Mr Charles Raymond Jordan, FNP - Medicare Nurse Practitioner 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



Provider's Profile

Full NameMr Charles Raymond Jordan
GenderMale
SpecialityNurse Practitioner
Experience13 Years
Location1350 Sunset Dr Ste B, Grenada, Mississippi
Accepts Medicare AssignmentsYes. 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.
IdentifierTypeStateIssuer
1306126263NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family R869908 (Mississippi)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Greenwood Leflore HospitalGreenwood, MSHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Fast Pace Mississippi Pllc3678832029136
Wound Management Specialists Llc519305636492

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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 NameGreenwood Leflore Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1699714717
PECOS PAC ID: 1153399472
Enrollment ID: O20040923000500

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Entity NameFast Pace Mississippi Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1447769559
PECOS PAC ID: 3678832029
Enrollment ID: O20180111000291

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Entity NameHealthcare Plus Limited Liability Company
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1063927465
PECOS PAC ID: 5698038610
Enrollment ID: O20180404001439

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Entity NameWound Management Specialists Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1972150084
PECOS PAC ID: 5193056364
Enrollment ID: O20191021000339

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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. 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 AddressPractice 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

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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
Courtney Bullard, AGNP-C
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 1966 F S Hill Dr, Grenada, MS 38901
Phone: 662-688-1519    
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    

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