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

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: August 16, 2026.

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.

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.

ERIC JOHNSON
Pharmacist
1900 SOUTH AVE
LA CROSSE, WI 54601
La Crosse County (608) 775-0520
ASHLEY RICKAWAY
Occupational Therapist
1900 SOUTH AVE
LA CROSSE, WI 54601
La Crosse County (608) 782-7300
MICHAELA PETTIT PHARMD
Pharmacist
1900 SOUTH AVE
LA CROSSE, WI 54601
La Crosse County (608) 782-7300
KJERSTEN RENAE FOLSTAD APRN
Nurse Practitioner (Family)
1900 SOUTH AVE
LA CROSSE, WI 54601
La Crosse County (507) 429-1509
DR. HEATHER JO WICHMAN M.D.
Radiology (Vascular & Interventional Radiology)
1900 SOUTH AVE
LA CROSSE, WI 54601
La Crosse County (608) 775-6569
AMBER THIEDE RN
Registered Nurse (Oncology)
1900 SOUTH AVE
LA CROSSE, WI 54601
La Crosse County (608) 387-4108
SARAH E GRABOSKI MS CCC-SLP
Speech-Language Pathologist
1900 SOUTH AVE
LA CROSSE, WI 54601
La Crosse County (920) 412-8047
JEFFREY P REILAND CADC
Counselor (Professional)
1900 SOUTH AVE
LA CROSSE, WI 54601
La Crosse County (608) 775-2287

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 Jordan Shortreed's NPI number?

The NPI number for Jordan Shortreed is 1417650607. It was assigned to this individual provider in the NPPES registry on March 24, 2023.

Where is Jordan Shortreed located?

Jordan Shortreed practices at 1900 South Ave, La Crosse, WI 54601. The listed phone number is (608) 782-7300.

What is Jordan Shortreed's specialty?

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

Is Jordan Shortreed enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Jordan Shortreed was last updated on March 24, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.