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

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Mr Charles Raymond Jordan, FNP is a medicare enrolled "Nurse Practitioner - Family" in Grenada, Mississippi. He graduated from nursing school in 2011 and has 15 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, Rapid Track Urgent Care, Llc, Fast Pace Mississippi Pllc 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 NameMr Charles Raymond Jordan
GenderMale
SpecialityNurse Practitioner
Experience15 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
Sta Home Health And HospiceGreenwood, MSHome health agency
Greenwood Leflore HospitalGreenwood, MSHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Fast Pace Mississippi Pllc3678832029170
Wound Management Specialists Llc5193056364123
Rapid Track Urgent Care, Llc88204319435
Fast Pace Mississippi Pllc3678832029170

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
Entity NameFast Pace Mississippi Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1447769559
PECOS PAC ID: 3678832029
Enrollment ID: O20180111000291
Entity NameHealthcare Plus Limited Liability Company
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1063927465
PECOS PAC ID: 5698038610
Enrollment ID: O20180404001439
Entity NameWound Management Specialists Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1972150084
PECOS PAC ID: 5193056364
Enrollment ID: O20191021000339
Entity NameRapid Track Urgent Care, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1003529652
PECOS PAC ID: 8820431943
Enrollment ID: O20240206002025
Entity NameDermaccel
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1992582241
PECOS PAC ID: 7618323130
Enrollment ID: O20241024004563

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

Reviews and Comments


Nurse Practitioner Nurses in Grenada, MS

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
Anna Cooper,
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 340 Van Dorn St Ste A, Grenada, MS 38901
Phone: 662-226-0325    
Mrs. Ashley Nicole Woods, FNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
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: 662-294-9101    Fax: 662-294-9104
Shonda Jacqueline Phelon, C.F.N.P.; P.M.H.N.P
Nurse Practitioner
Medicare: Medicare Enrolled
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

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.