Mr Charles Raymond Jordan, FNP in Grenada, MS

Mr Charles Raymond Jordan, FNP is a medicare enrolled "Nurse Practitioner - Family" in Grenada, Mississippi. He graduated from nursing school in 2011 and has 13 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Fast Pace Mississippi Pllc, Wound Management Specialists Llc and his current practice location is 1350 Sunset Dr Ste B, Grenada, Mississippi. You can reach out to his office (for appointments etc.) via phone at (662) 466-3632.

Mr Charles Raymond Jordan is licensed to practice in Mississippi (license number R869908) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1306126263.

Contact Information

	Mr Charles Raymond Jordan, FNP
	1350 Sunset Dr Ste B, Grenada, MS 38901-4079
	(662) 466-3632
	Not Available

Map and Direction

Provider's Profile

Full Name	Mr Charles Raymond Jordan
Gender	Male
Speciality	Nurse Practitioner
Experience	13 Years
Location	1350 Sunset Dr Ste B, Grenada, Mississippi
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mr Charles Raymond Jordan graduated from nursing school in 2011

NPI Data:

NPI Number: 1306126263
Provider Enumeration Date: 08/24/2011
Last Update Date: 08/24/2011

Medicare PECOS Information:

PECOS PAC ID: 8628235744
Enrollment ID: I20120201000504

Medical Identifiers

Medical identifiers for Mr Charles Raymond Jordan such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1306126263	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	R869908 (Mississippi)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Greenwood Leflore Hospital	Greenwood, MS	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Fast Pace Mississippi Pllc	3678832029	142
Wound Management Specialists Llc	5193056364	94

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. Mr Charles Raymond Jordan allows following entities to bill medicare on his behalf.

Entity Name	Greenwood Leflore Hospital
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1699714717 PECOS PAC ID: 1153399472 Enrollment ID: O20040923000500

Entity Name	Fast Pace Mississippi Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1447769559 PECOS PAC ID: 3678832029 Enrollment ID: O20180111000291

Entity Name	Healthcare Plus Limited Liability Company
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1063927465 PECOS PAC ID: 5698038610 Enrollment ID: O20180404001439

Entity Name	Wound Management Specialists Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1972150084 PECOS PAC ID: 5193056364 Enrollment ID: O20191021000339

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. Mr Charles Raymond 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
Mr Charles Raymond Jordan, FNP Po Box 395, N.carrollton, MS 38947-0395 Ph: (662) 466-3632	Mr Charles Raymond Jordan, FNP 1350 Sunset Dr Ste B, Grenada, MS 38901-4079 Ph: (662) 466-3632

Reviews and Comments

Nurse Practitioner Nurses in Grenada, MS

Kelsey Marter Faulkner, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 965 Avent Dr, Grenada, MS 38901 Phone: 601-815-2005
Mrs. Agnes Pamela Upchurch, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1350 Sunset Dr, Ste B, Grenada, MS 38901 Phone: 662-229-0669 Fax: 662-227-9929
Mrs. Ashley Nicole Woods, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 140 Broadfield Dr, Grenada, MS 38901 Phone: 662-809-2419
Latia Monanette Butts, CFNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1300 Sunset Dr, Ste Q, Grenada, MS 38901 Phone: 662-349-2442 Fax: 662-349-8551
Shonda Jacqueline Phelon, C.F.N.P.; P.M.H.N.P Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1970 Grandview Dr, Grenada, MS 38901 Phone: 662-227-3700 Fax: 662-227-3740
Alison Campbell, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1117 Sunset Dr Ste 104, Grenada, MS 38901 Phone: 662-226-0110
Ralph T Cain, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1300 Sunset Dr, Ste Q, Grenada, MS 38901 Phone: 662-294-9101 Fax: 662-294-9104

Mr Charles Raymond Jordan, FNP - Medicare Nurse Practitioner in Grenada, MS