MS. KIMBERLY R JORDAN – Registered Dietitian, NPI 1609111640

MS. KIMBERLY R JORDAN is a healthcare provider. based in Longmont, Colorado. specializing in REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL. They hold a License No. LD-0824 (NM). The NPI Number for MS. KIMBERLY R JORDAN is 1609111640

Main info

Female
18 Years Of Experience
Accepts Medicare Assignment
Name
MS. KIMBERLY R JORDAN
NPI
1609111640
Phone
(303) 776-1234
Address
1925 MOUNTAIN VIEW AVE
Enumeration Date
3 December 2012
Last Update Date
27 December 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7207335260
Graduation Year
2008 (18 years ago)
PAC ID
2668775354
Group Practice PAC ID
9638208549
Professional Enrollment ID
I20160130000134
Address ID
CO801047419CA4404XLNXX302
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience49
Completeness75
Years active:13State licenses:2Digital endpointsOther names

137 REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL in CO

Provider Addresses for MS. KIMBERLY R JORDAN

  • 1925 MOUNTAIN VIEW AVE

    LONGMONT, CO 805013128

    Phone: (303) 776-1234

    Fax: (720) 494-3107

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2016-01-30

PECOS data refreshed: 2026-06-15

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20160130000134IRegistered Dietitian Or Nutrition ProfessionalCOTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
G0108Diabetes outpatient self-management training services, individual, per 30 minutes5928$0
View full utilization report →

Insurance plans in this area (ZIP 80501)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9638208549View full group profile
NameSpecialtyState
Pulmonary DiseaseCO
-CO
-CO
-MO
Physician AssistantCO
-CO
Hospitalist, Internal MedicineNY
Physician AssistantCO
Physician AssistantCO
Nurse PractitionerCO

Reviews

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Frequently asked questions

What is the 10-digit NPI for MS. KIMBERLY R JORDAN?
MS. KIMBERLY R JORDAN — NPI 1609111640 — is the standard way to identify this listing.
Is MS. KIMBERLY R JORDAN listed as active for patients and plans?
The listing shows MS. KIMBERLY R JORDAN as active in the NPI system.
What is MS. KIMBERLY R JORDAN best known for clinically?
Directory data describes MS. KIMBERLY R JORDAN with Registered Dietitian. Clinical services aligned with this taxonomy classification.
Where should I expect MS. KIMBERLY R JORDAN on a map?
Expect Longmont, Colorado as a primary anchor for MS. KIMBERLY R JORDAN unless the record lists multiple sites.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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