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SHAUN MICHELLE JORDAN REGISTERED NURSE
NPI 1245453372
Registered Nurse - Obstetric, Inpatient in Lynwood, CA

Active since April 10, 2007PECOS Enrolled
3633 MARTIN LUTHER KING JR BLVD STE 3, LYNWOOD, CA 90262(310) 763-3075(310) 763-3084 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Shaun Michelle Jordan Registered Nurse NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHAUN MICHELLE JORDAN REGISTERED NURSE (NPI 1245453372) is an individual obstetric, inpatient provider in Lynwood, California, licensed in California (RN417181) and active in the NPI registry since April 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1245453372
Entity TypeIndividualFemale
Primary Taxonomy163WX0003X
Provider Legal NameSHAUN MICHELLE JORDANCredential: REGISTERED NURSE
Location Address3633 MARTIN LUTHER KING JR BLVD STE 3Lynwood, CA 90262-3510
Mailing Address19437 Tajauta AveCarson, CA 90746-2748 · (310) 638-1287 · Fax (310) 763-3084
Phone(310) 763-3075
Fax(310) 763-3084
Sole ProprietorYes
Enumeration DateApril 10, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1245453372 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRegistered Nurse · Obstetric, InpatientNursing Service Providers
Taxonomy Code163WX0003X
License✔ Licensed in CA · RN417181
3633 MARTIN LUTHER KING JR BLVD STE 3, Lynwood, CA 90262
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shaun Michelle Jordan Registered Nurse is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Shaun Jordan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

St. Johns Community Health
0.1 mi
Family Planning, Non-Surgical
3628 E IMPERIAL HWY STE 301
Lynwood, CA 90262
  • Reassigned Medicare billing, California enrollment
  • Medicare enrollment name: St. John's Community Health
  • 404 clinicians in this Medicare group
NPI 1063836526 (323) 541-1600

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shaun Jordan's NPI number?

The NPI number for Shaun Jordan is 1245453372. It was assigned to this individual provider in the NPPES registry on April 10, 2007.

Where is Shaun Jordan located?

Shaun Jordan practices at 3633 Martin Luther King Jr Blvd Ste 3, Lynwood, CA 90262. The listed phone number is (310) 763-3075.

What is Shaun Jordan's specialty?

The primary specialty registered for this NPI is Registered Nurse, specializing in Obstetric, Inpatient, with taxonomy code 163WX0003X.

Is Shaun Jordan enrolled in Medicare?

Yes. Shaun Jordan is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Shaun Jordan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shaun Jordan reassigns Medicare benefits to St. Johns Community Health (Lynwood, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shaun Jordan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Shaun Jordan was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.