Jacquita Jordan, FNP-BC, AGACNP is a medicare enrolled "Nurse Practitioner - Family" physician in Colorado Springs, Colorado. She graduated from medical school in 2015 and has 9 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Fountain Valley Health Care Llc and her current practice location is
1259 Lake Plaza Dr Ste 270, Colorado Springs, Colorado. You can reach out to her office (for appointments etc.) via phone at
(719) 653-7776.
Jacquita Jordan is licensed to practice in Colorado (license number 0991885) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1730558834.
Physician's Profile
| Full Name | Jacquita Jordan |
|---|
| Gender | Female |
|---|
| Speciality | Nurse Practitioner |
|---|
| Experience | 9 Years |
|---|
| Location | 1259 Lake Plaza Dr Ste 270, Colorado Springs, Colorado |
|---|
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
|---|
Medical Education and Training:
- Jacquita Jordan graduated from medical school in 2015
NPI Data:
- NPI Number: 1730558834
- Provider Enumeration Date: 09/18/2015
- Last Update Date: 02/12/2024
Medicare PECOS Information:
- PECOS PAC ID: 1759682842
- Enrollment ID: I20151215000493
Medical Identifiers
Medical identifiers for Jacquita Jordan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1730558834 | NPI | - | NPPES |
| 42820065 | Medicaid | CO | |
| 9000108092 | Medicaid | CO | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207QA0401X | Family Medicine - Addiction Medicine | APN.0991885-NP (Colorado) | Secondary |
| 363LA2100X | Nurse Practitioner - Acute Care | APN.0991885-NP (Colorado) | Secondary |
| 363LA2200X | Nurse Practitioner - Adult Health | 0991885 (Colorado) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | APN.0991885-NP (Colorado) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 0991885 (Colorado) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Fountain Valley Health Care Llc | 6608252663 | 2 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jacquita Jordan allows following entities to bill medicare on her behalf.
| Entity Name | Poudre Valley Medical Group Llc |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1366763260
PECOS PAC ID: 9638208549
Enrollment ID: O20100602000122 |
|---|
| Entity Name | Fountain Valley Health Care Llc |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1275272924
PECOS PAC ID: 6608252663
Enrollment ID: O20220929000653 |
|---|
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jacquita Jordan is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jacquita Jordan, FNP-BC, AGACNP
10265 Rolling Ridge Rd,
Colorado Springs, CO 80925-9509
Ph: (719) 653-7776 | Jacquita Jordan, FNP-BC, AGACNP
1259 Lake Plaza Dr Ste 270,
Colorado Springs, CO 80906-3560
Ph: (719) 653-7776 |
Reviews and Comments