KIMBERLY ELIZABETH JORDAN MD
NPI 1457315947
Family Medicine in Atlanta, GA
About Kimberly Elizabeth Jordan Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KIMBERLY ELIZABETH JORDAN MD (NPI 1457315947) is an individual family medicine provider in Atlanta, Georgia, licensed in Georgia (105060) and active in the NPI registry since April 2006. She is enrolled in Medicare PECOS and is a graduate of Wright State University Boonshoft School Of Medicine (2001).
NPPES Registry Identity
Specialties & Licenses
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
Kimberly Elizabeth Jordan Md 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.
Medicare Billing Reassignments
3Medicare enrollment records show Kimberly Jordan reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Atlanta, GA 30305
- Reassigned Medicare billing, Georgia enrollment
- 1,389 clinicians in this Medicare group
Boiling Springs, NC 28017
- Reassigned Medicare billing, North Carolina enrollment
- 673 clinicians in this Medicare group
Newton, NC 28658
- Reassigned Medicare billing, North Carolina enrollment
- 49 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 30342 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Referred Medical Equipment & Supplies CMS DME claims 2
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
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 Kimberly Jordan's NPI number?
The NPI number for Kimberly Jordan is 1457315947. It was assigned to this individual provider in the NPPES registry on April 13, 2006.
Where is Kimberly Jordan located?
Kimberly Jordan practices at 1100 Lake Hearn Dr Ste 450, Atlanta, GA 30342. The listed phone number is (404) 365-0966.
What is Kimberly Jordan's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Kimberly Jordan enrolled in Medicare?
Yes. Kimberly 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 Kimberly Jordan's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Jordan reassigns Medicare benefits to 3 organizations: The Southeast Permanente Medical Group (Atlanta, GA), Caromont Medical Group Inc (Boiling Springs, NC) and Carolina Caring Serious Illness, LLC (Newton, NC). 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 Kimberly 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 Kimberly Jordan was last updated on September 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.
# Kimberly Elizabeth Jordan, MD · NPI 1457315947
Family Medicine physician in Atlanta, Georgia. Individual provider, active in the CMS NPPES registry since April 13, 2006.
## Identity
- **NPI:** 1457315947 (Entity type: Individual)
- **Enumerated:** April 13, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 105060 (Georgia)
- **Sole proprietor:** No
## Practice location
- **Address:** 1100 LAKE HEARN DR STE 450, Atlanta, GA 30342-1524
- **Phone:** (404) 365-0966
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): The Southeast Permanente Medical Group (NPI 1245266956, Atlanta, GA); Caromont Medical Group Inc (NPI 1205079290, Boiling Springs, NC); Carolina Caring Serious Illness, LLC (NPI 1083449680, Newton, NC) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Wright State University Boonshoft School Of Medicine, class of 2001
## Record status
- **NPPES last updated:** September 16, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1457315947) · Data from the CMS NPPES public registry.