David Willis Jordan, CRNA - Medicare Nurse Anesthetist, Certified Registered in Iola, KS

David Willis Jordan, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Iola, Kansas. His current practice location is 101 South First Street, Iola, Kansas. You can reach out to his office (for appointments etc.) via phone at (620) 365-1000.

David Willis Jordan is licensed to practice in Kansas (license number 54054) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1083684559.

Contact Information

David Willis Jordan, CRNA
101 South First Street,
Iola, KS 66749
(620) 365-1000
Not Available



Provider's Profile

Full NameDavid Willis Jordan
GenderMale
SpecialityNurse Anesthetist, Certified Registered
Location101 South First Street, Iola, Kansas
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1083684559
  • Provider Enumeration Date: 01/25/2006
  • Last Update Date: 05/12/2011
  Medicare PECOS Information:
  • PECOS PAC ID: 8729053145
  • Enrollment ID: I20040830000670

Medical Identifiers

Medical identifiers for David Willis Jordan such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1083684559NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367500000XNurse Anesthetist, Certified Registered 54054 (Kansas)Primary

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. David Willis Jordan allows following entities to bill medicare on his behalf.
Entity NameSouth Central Anesthesia Llp
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1376502294
PECOS PAC ID: 9537127659
Enrollment ID: O20041221000620

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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. David Willis 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 AddressPractice Location Address
David Willis Jordan, CRNA
Po Box 388,
Newton, KS 67114-0388

Ph: (316) 281-3700
David Willis Jordan, CRNA
101 South First Street,
Iola, KS 66749

Ph: (620) 365-1000

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Nurse Anesthetist, Certified Registered Nurses in Iola, KS

Charles Cory Hallacy,
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 3066 N Kentucky St, Iola, KS 66749
Phone: 620-365-1000    

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