DR. WADE THOMAS JORDAN M..D. NPI 1326135781

NPI Information

NPI: 1326135781
Provider Name: DR. WADE THOMAS JORDAN, M..D.
Classification: Internal Medicine - 207RN0300X
Entity Type: Individual

Specialization: Nephrology

Address:
1911 S NATIONAL AVE
SUITE 301
SPRINGFIELD, MO
ZIP 65804
Phone: (417) 886-5000
Get Directions

DR. Wade Thomas Jordan, M..D. is a nephrology internal medicine in Springfield, MO. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. DR. Wade Thomas Jordan, M..D. NPI is 1326135781. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1911 S NATIONAL AVE
SUITE 301
SPRINGFIELD, MO
ZIP 65804-219
Phone: (417) 886-5000
Fax: (417) 886-1100

The enumeration date for this NPI number is 10/6/2006 and was last updated on 12/1/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RN0300X	Internal Medicine	Nephrology	R4P99	MISSOURI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	C17628	MEDICARE UPIN
2	002012599	OTHER	MISSOURI	MEDICARE PTAN
3	122036001	MEDICAID	ARKANSAS
4	153509	OTHER		HEALTHLINK
5	203047915	MEDICAID	MISSOURI
6	390003925	OTHER		RAILROAD MEDICARE
7	25183	OTHER	MISSOURI	BLUE CROSS BLUE SHIELD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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