JORDAN SHORTREED
NPI 1417650607
Student in an Organized Health Care Education/Training Program in La Crosse, WI

Q: What is the provider's specialty?

The provider's specialty is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since March 24, 2023PECOS Enrolled

1900 SOUTH AVE, LA CROSSE, WI 54601(608) 782-7300 Get Directions Write a Review

NPPES record last updated: March 24, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Jordan Shortreed NPPES

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

JORDAN SHORTREED (NPI 1417650607) is an individual student in an organized health care education/training program in La Crosse, Wisconsin and active in the NPI registry since March 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417650607

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameJORDAN SHORTREED

Location Address1900 SOUTH AVELa Crosse, WI 54601-5467

Mailing Address1900 South AveLa Crosse, WI 54601-5467 · (608) 782-7300

Phone(608) 782-7300

Sole ProprietorNo

Enumeration DateMarch 24, 2023

NPPES CertifiedMarch 24, 2023

✔ NPI 1417650607 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

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.

1900 SOUTH AVE, La Crosse, WI 54601

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jordan Shortreed 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.