MR. RICHARD DEAN JORDAN
NPI 1265060453
Student in an Organized Health Care Education/Training Program in Winston Salem, NC

Active since April 01, 2020PECOS Enrolled
1 MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157(336) 716-4311 Get Directions Write a Review

NPPES record last updated: April 1, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mr. Richard Dean Jordan NPPES

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

MR. RICHARD DEAN JORDAN (NPI 1265060453) is an individual student in an organized health care education/training program in Winston Salem, North Carolina and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1265060453
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMR. RICHARD DEAN JORDAN
Location Address1 MEDICAL CENTER BLVDWinston Salem, NC 27157-0001
Mailing Address603 N Carolina AveStatesville, NC 28677-3330 · (704) 775-3436
Sole ProprietorNo
Enumeration DateApril 1, 2020
NPPES CertifiedApril 1, 2020
NPI 1265060453 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1 MEDICAL CENTER BLVD, Winston Salem, NC 27157

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Mr. Richard Dean Jordan 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.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Obstetrics & Gynecology
1 MEDICAL CENTER BLVD
WINSTON-SALEM, NC 27157
Student in an Organized Health Care Education/Training Program
1 MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Student in an Organized Health Care Education/Training Program
1 MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Student in an Organized Health Care Education/Training Program
1 MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Student in an Organized Health Care Education/Training Program
1 MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Nurse Practitioner (Family)
1 MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Student in an Organized Health Care Education/Training Program
1 MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Genetic Counselor, MS
1 MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157

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 Richard Jordan's NPI number?

The NPI number for Richard Jordan is 1265060453. It was assigned to this individual provider in the NPPES registry on April 1, 2020.

Where is Richard Jordan located?

Richard Jordan practices at 1 Medical Center Blvd, Winston Salem, NC 27157. The listed phone number is (336) 716-4311.

What is Richard Jordan's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Richard Jordan enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Richard Jordan was last updated on April 1, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.