MR. GLEN S. JORDAN PA-C
NPI 1790885341
Physician Assistant - Medical in Huntington, WV

Q: What is Glen Jordan's NPI number?

The NPI number for Glen Jordan is 1790885341. It was assigned to this individual provider in the NPPES registry on September 24, 2006.

Q: What is Glen Jordan's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Glen Jordan was last updated on April 13, 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.

Active since September 24, 2006PECOS EnrolledAccepts Medicare Assignment

1340 HAL GREER BLVD, HUNTINGTON, WV 25701(304) 399-6727(304) 399-6726 Get Directions Write a Review

NPPES record last updated: April 13, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mr. Glen S. Jordan Pa-c NPPES

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

MR. GLEN S. JORDAN PA-C (NPI 1790885341) is an individual medical provider in Huntington, West Virginia, licensed in West Virginia (01222) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS and is a graduate of Other (2006).

NPPES Registry Identity

NPI1790885341

Entity TypeIndividualMale

Primary Taxonomy363AM0700X

Provider Legal NameMR. GLEN S. JORDANCredential: PA-C

Location Address1340 HAL GREER BLVDHuntington, WV 25701-3804

Mailing Address1340 Hal Greer BlvdHuntington, WV 25701-3804 · (304) 399-6727 · Fax (304) 399-6726

Phone(304) 399-6727

Fax(304) 399-6726

Sole ProprietorNo

Medical School CMSOtherGraduated 2006

Enumeration DateSeptember 24, 2006

Last NPPES UpdateApril 13, 2021

NPPES CertifiedApril 13, 2021

✔ NPI 1790885341 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in WV · 01222

1340 HAL GREER BLVD, Huntington, WV 25701

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Other Identifiers 4

Medicaid7100118540KY

OtherP00711764WV · Medicare Rr

Medicaid1790885341WV

Medicaid0080124OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Glen S. Jordan Pa-c 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 ID8325115579

PECOS Enrollment IDI20080930000404

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.

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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.

AMINA AWAN MD

Internal Medicine