SAMANTHA R JORDAN PSYD
NPI 1366786527
Psychologist in Marietta, GA

Active since November 12, 2012Accepts Medicare Assignment
2520 WINDY HILL RD SE, SUITE 203, MARIETTA, GA 30067(770) 953-6401(770) 953-6015 Get Directions Write a Review

NPPES record last updated: November 12, 2012. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Samantha R Jordan Psyd NPPES

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

SAMANTHA R JORDAN PSYD (NPI 1366786527) is an individual psychologist in Marietta, Georgia, licensed in Georgia (PSY003632) and active in the NPI registry since November 2012. She is a graduate of Other (2007).

NPPES Registry Identity

NPI1366786527
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameSAMANTHA R JORDANCredential: PSYD
Location Address2520 WINDY HILL RD SE, SUITE 203Marietta, GA 30067-8664
Mailing Address2520 Windy Hill Rd Se, Suite 203Marietta, GA 30067-8664 · (770) 953-6401 · Fax (770) 953-6015
Fax(770) 953-6015
Sole ProprietorNo
Medical School CMSOtherGraduated 2007
Enumeration DateNovember 12, 2012
✔ NPI 1366786527 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in GA · PSY003632
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
2520 WINDY HILL RD SE, Marietta, GA 30067

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Samantha R Jordan Psyd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID244556975
PECOS Enrollment IDI20150224000696

Medicare Billing Reassignments

2

Medicare enrollment records show Samantha Jordan reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Psychologist
2520 WINDY HILL RD SE, SUITE 203
Marietta, GA 30067
  • Reassigned Medicare billing, Georgia enrollment
  • 6 clinicians in this Medicare group
Clinical
12461 VETERANS MEMORIAL HWY STE 794
Douglasville, GA 30134
  • Reassigned Medicare billing, Georgia enrollment

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

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.

Orthopaedic Surgery
2520 WINDY HILL RD SE, SUITE 202
MARIETTA, GA 30067
Family Medicine
2520 WINDY HILL RD SE, SUITE 301
MARIETTA, GA 30067
Clinic/Center (Podiatric)
2520 WINDY HILL RD SE, SUITE 105
MARIETTA, GA 30067
Psychologist
2520 WINDY HILL RD SE, SUITE 203
MARIETTA, GA 30067
Psychologist
2520 WINDY HILL RD SE, SUITE 203
MARIETTA, GA 30067
Psychologist (Clinical)
2520 WINDY HILL RD SE, SUITE 203
MARIETTA, GA 30067
Nurse Practitioner (Pediatrics)
2520 WINDY HILL RD SE, SUITE NUMBER 104
MARIETTA, GA 30067
Internal Medicine (Gastroenterology)
2520 WINDY HILL RD SE, SUITE 102
MARIETTA, GA 30067

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 Samantha Jordan's NPI number?

The NPI number for Samantha Jordan is 1366786527. It was assigned to this individual provider in the NPPES registry on November 12, 2012.

Where is Samantha Jordan located?

Samantha Jordan practices at 2520 Windy Hill Rd SE Suite 203, Marietta, GA 30067. The listed phone number is (770) 953-6401.

What is Samantha Jordan's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Samantha Jordan enrolled in Medicare?

Yes. Samantha Jordan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Samantha Jordan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samantha Jordan reassigns Medicare benefits to 2 organizations: Atlanta Area Psychological Associates, P.C. (Marietta, GA) and Insight Psychological Solutions LLC (Douglasville, GA). Each 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 Samantha Jordan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Samantha Jordan accept?

Health plans from Oscar Health list Samantha Jordan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Samantha Jordan was last updated on November 12, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.