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JORDAN RAY NOBLE DNP, APRN, AGACNP-BC
NPI 1891310538
Nurse Practitioner - Acute Care in San Diego, CA

Active since June 09, 2020PECOS Enrolled
4077 FIFTH AVE, SAN DIEGO, CA 92103(312) 402-5335 Get Directions Write a Review

NPPES record last updated: May 22, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 22, 2025, Oct 13, 2020, Jun 9, 2020 (3 updates tracked since 2020).

About Jordan Ray Noble Dnp, Aprn, Agacnp-bc NPPES

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

JORDAN RAY NOBLE DNP, APRN, AGACNP-BC (NPI 1891310538) is an individual acute care provider in San Diego, California, licensed in California (95014440) and active in the NPI registry since June 2020. He is enrolled in Medicare PECOS and maintains a secondary practice location in Chicago.

NPPES Registry Identity

NPI1891310538
Entity TypeIndividualMale
Primary Taxonomy363LA2100X
Provider Legal NameJORDAN RAY NOBLECredential: DNP, APRN, AGACNP-BC
Location Address4077 FIFTH AVESan Diego, CA 92103-2105
Mailing Address4077 Fifth AveSan Diego, CA 92103-2105 · (619) 686-3789
Phone(312) 402-5335
Sole ProprietorNo
Enumeration DateJune 9, 2020
Last NPPES UpdateMay 22, 20253 updates tracked since enumeration
NPPES CertifiedMay 22, 2025
✔ NPI 1891310538 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
Licenses✔ Licensed in CA · 95014440✔ Licensed in IL · 209021013
Also ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X · License 209.021013 (IL)
4077 FIFTH AVE, San Diego, CA 92103
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Secondary Practice Location 1

Location 15841 S Maryland AveChicago, IL 60637-1443 · Phone (312) 402-5335

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 Ray Noble Dnp, Aprn, Agacnp-bc 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92103 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$94.87 typical visit price
range $62.10 – $184.71
Typical copayment $23.71 (range $15.52 – $46.17)
Most-billed visit code 99203
Established Patient
$108.42 typical visit price
range $20.62 – $151.42
Typical copayment $27.10 (range $5.15 – $37.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

BRIAN BUTLER M.D.
Hospitalist
4077 FIFTH AVE
SAN DIEGO, CA 92103
San Diego County (619) 686-3935
DR. SCOT NOLAN DNP, RN, CNS
Clinical Nurse Specialist (Critical Care Medicine)
4077 FIFTH AVE
SAN DIEGO, CA 92103
San Diego County (619) 686-3595
DR. ARASH ABIRI MD, PHD
Student in an Organized Health Care Education/Training Program
4077 FIFTH AVE
SAN DIEGO, CA 92103
San Diego County (185) 883-2247
BRIANNA ELISE LIPSEY RN, BSN
Registered Nurse (Neuroscience)
4077 FIFTH AVE
SAN DIEGO, CA 92103
San Diego County (858) 832-2478
PAUL JIN HAN M.D.
Internal Medicine
4077 FIFTH AVE, MER 35
SAN DIEGO, CA 92103
San Diego County (619) 260-7022
CHRISTIAN NGUYEN KELLY
Emergency Medicine
4077 FIFTH AVE
SAN DIEGO, CA 92103
San Diego County (619) 294-8111
LINA MOHAMMED DO
Student in an Organized Health Care Education/Training Program
4077 FIFTH AVE
SAN DIEGO, CA 92103
San Diego County (619) 260-7220
AMY MARIE SANTOS CCRN, MSN, ACNP
Nurse Practitioner (Acute Care)
4077 FIFTH AVE, TRAUMA SERVICES, MER62
SAN DIEGO, CA 92103
San Diego County (619) 260-7285

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 Noble's NPI number?

The NPI number for Jordan Noble is 1891310538. It was assigned to this individual provider in the NPPES registry on June 9, 2020.

Where is Jordan Noble located?

Jordan Noble practices at 4077 Fifth Ave, San Diego, CA 92103. The listed phone number is (312) 402-5335.

What is Jordan Noble's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is Jordan Noble enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Jordan Noble was last updated on May 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.