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MR. JEREMY TODD JORDAN PA-C, MBA
NPI 1790729614
Physician Assistant in Charleston, WV

Active since June 15, 2006
3200 MACCORKLE AVE SE, CHARLESTON, WV 25304(304) 388-5432 Get Directions Write a Review

NPPES record last updated: August 3, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 3, 2021, Jul 15, 2021 (2 updates tracked since 2021).

About Mr. Jeremy Todd Jordan Pa-c, Mba NPPES

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

MR. JEREMY TODD JORDAN PA-C, MBA (NPI 1790729614) is an individual physician assistant in Charleston, West Virginia, licensed in West Virginia (823) and active in the NPI registry since June 2006. He maintains a secondary practice location in Charleston.

NPPES Registry Identity

NPI1790729614
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. JEREMY TODD JORDANCredential: PA-C, MBA
Location Address3200 MACCORKLE AVE SECharleston, WV 25304-1297
Mailing Address2300 Maccorkle Ave SeCharleston, WV 25304-1099 · (304) 357-4790
Phone(304) 388-5432
Sole ProprietorNo
Enumeration DateJune 15, 2006
Last NPPES UpdateAugust 3, 20212 updates tracked since enumeration
NPPES CertifiedAugust 3, 2021
✔ NPI 1790729614 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in WV · 823
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
3200 MACCORKLE AVE SE, Charleston, WV 25304
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Other Names 1

Other Name (5)Todd Jordan Pa-c, Mba

Secondary Practice Location 1

Location 14602 MacCorkle Ave SECharleston, WV 25304-1848 · Phone (304) 925-4777 · Fax (304) 925-4780

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.

CAMERON DUBA DO
Emergency Medicine
3200 MACCORKLE AVE SE
CHARLESTON, WV 25304
Kanawha County (304) 388-4172
WILLIAM JARRETT WISEMAN BSN, RN, CCRN-CMC
Registered Nurse
3200 MACCORKLE AVE SE
CHARLESTON, WV 25304
Kanawha County (304) 993-1088
MS. BRENDA LOU KEEFER ANP
Nurse Practitioner (Family)
3200 MACCORKLE AVE SE
CHARLESTON, WV 25304
Kanawha County (304) 925-3436
LOUISE NAYLOR
Nurse Anesthetist, Certified Registered
3200 MACCORKLE AVE SE
CHARSTON, WV 25304
Kanawha County (304) 388-4077
DR. JEFFREY V ASHLEY M.D.
Family Medicine
3200 MACCORKLE AVE SE, FIFTH FLOOR
CHARLESTON, WV 25304
Kanawha County (304) 388-4600
TIFFANY D. DUTTON CRNA
Nurse Anesthetist, Certified Registered
3200 MACCORKLE AVE SE, DEPT. OF SURGERY
CHARLESTON, WV 25304
Kanawha County (304) 388-5503
JENNIFER D VALDEZ
Nurse Anesthetist, Certified Registered
3200 MACCORKLE AVE SE
CHARLESTON, WV 25304
Kanawha County (304) 388-5432
CHRISTOPHER S MULLINS
Nurse Anesthetist, Certified Registered
3200 MACCORKLE AVE SE
CHARLESTON, WV 25304
Kanawha County (304) 688-0228

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 Jeremy Jordan's NPI number?

The NPI number for Jeremy Jordan is 1790729614. It was assigned to this individual provider in the NPPES registry on June 15, 2006. The provider is also known as Todd Jordan Pa-C, Mba.

Where is Jeremy Jordan located?

Jeremy Jordan practices at 3200 Maccorkle Ave SE, Charleston, WV 25304. The listed phone number is (304) 388-5432.

What is Jeremy Jordan's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Jeremy Jordan was last updated on August 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.