JORDAN BASS WALD (CRNP) – Family Nurse Practitioner, NPI 1043757784
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,653 NURSE PRACTITIONER in AL
Provider Addresses for JORDAN BASS WALD (CRNP)
1575 MONTGOMERY HWY
VESTAVIA HILLS, AL 352164510
Phone: (205) 822-1150
Fax: (205) 822-1158
Type: Location
3909, McFarland Boulevard, Harper Subdivision, Northport, Tuscaloosa County, Alabama, 35476, United States
NORTHPORT, AL 354762838
Phone: (205) 330-1707
Fax: (205) 333-0782
Type: Location
8000 LIBERTY PKWY STE 114
VESTAVIA, AL 352427563
Phone: (205) 968-5988
Fax: (205) 968-5990
Type: Location
1575, Montgomery Highway, Hoover, Jefferson County, Alabama, 35216, United States
VESTAVIA HILLS, AL 352164510
Phone: (205) 822-1150
Fax: (205) 822-1158
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $14.
Total Amount is formed as General ($14) + Research ($0) + Ownership ($0) = $14.
Last reported payment date: 2024-04-09 • Largest payer in this snapshot: PFIZER INC. ($14).
Total Amount
$14
General + Research + Ownership
Payments
1
Total payment records
General Amount
$14
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-04-09
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| PFIZER INC. | $14 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2018-09-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20180926000540 | I | Nurse Practitioner | AL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 250 | 33 | $0 |
| J0696 | Injection, ceftriaxone sodium, per 250 mg | 136 | 32 | $0 |
| 96372 | Injection of drug or substance under skin or into muscle | 70 | 51 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 44 | 44 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 28 | 26 | $0 |
Insurance plans in this area (ZIP 35216)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | AL | |
| Nurse Practitioner | AL | |
| Internal Medicine, Pediatric Medicine | AL | |
| Physician Assistant | AL | |
| Nurse Practitioner | AL | |
| Family Practice | AL | |
| Nurse Practitioner | AL | |
| Nurse Practitioner | AL | |
| General Surgery | AL | |
| Family Practice | AL |
Reviews
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