Jordan Blythe, PA-C is a medicare enrolled "Physician Assistant" in West Fork, Arkansas. He graduated from nursing school in 2022 and has 3 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Icco Llc and his current practice location is
451 Phillips St, West Fork, Arkansas. You can reach out to his office (for appointments etc.) via phone at
(479) 294-6085.
Jordan Blythe is licensed to practice in * (Not Available) (license number ) 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 1548972409.
Provider's Profile
| Full Name | Jordan Blythe |
|---|
| Gender | Male |
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| Speciality | Physician Assistant |
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| Experience | 3 Years |
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| Location | 451 Phillips St, West Fork, Arkansas |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Jordan Blythe graduated from nursing school in 2022
NPI Data:
- NPI Number: 1548972409
- Provider Enumeration Date: 12/21/2022
- Last Update Date: 04/10/2025
Medicare PECOS Information:
- PECOS PAC ID: 4981075769
- Enrollment ID: I20230116000388
Medical Identifiers
Medical identifiers for Jordan Blythe such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1548972409 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363A00000X | Physician Assistant | (* (Not Available)) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Icco Llc | 1355406729 | 108 |
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. Jordan Blythe 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 |
|---|
Jordan Blythe, PA-C
4196 Highway 62 412 Ste A,
Hardy, AR 72542-8002
Ph: () - | Jordan Blythe, PA-C
451 Phillips St,
West Fork, AR 72774-2813
Ph: (479) 294-6085 |
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