MR. JORDAN OFFICER – Certified Registered Nurse Anesthetist, NPI 1740977156

MR. JORDAN OFFICER is a healthcare provider. based in West des moines, Iowa. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold a License No. D185128 (IA). The NPI Number for MR. JORDAN OFFICER is 1740977156

Main info

Male
1 Year Of Experience
Accepts Medicare Assignment
Name
MR. JORDAN OFFICER
NPI
1740977156
Phone
(515) 473-0805
Address
1273 66TH ST
Enumeration Date
18 April 2023
Last Update Date
22 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5152244711
Graduation Year
2025 (1 year ago)
PAC ID
3779087507
Group Practice PAC ID
2961823596
Professional Enrollment ID
I20250916002668
Address ID
IA502661900WE1300XSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience35
Completeness85
Years active:3State licenses:1Digital endpointsOther names

522 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in IA

Provider Addresses for MR. JORDAN OFFICER

  • 1273 66TH ST

    WEST DES MOINES, IA 502665769

    Phone: (515) 473-0805

    Type: Mailing

  • 200 HAWKINS DR

    IOWA CITY, IA 522421009

    Phone: (319) 356-1616

    Type: Location

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: 2025-09-16

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250916002668ICertified Registered Nurse Anesthetist (Crna)IATBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 50266)

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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: 2961823596View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)IA
Certified Registered Nurse Anesthetist (Crna)IA
Certified Registered Nurse Anesthetist (Crna)IA
Certified Registered Nurse Anesthetist (Crna)IA
-MN
Certified Registered Nurse Anesthetist (Crna)IA
Certified Registered Nurse Anesthetist (Crna)IA
Certified Registered Nurse Anesthetist (Crna)IA
Certified Registered Nurse Anesthetist (Crna)ME
Certified Registered Nurse Anesthetist (Crna)IA

Reviews

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Frequently asked questions

Can I verify MR. JORDAN OFFICER with an NPI only?
You can start verification with NPI 1740977156 for MR. JORDAN OFFICER, then check state licensing separately.
Is MR. JORDAN OFFICER still practicing?
MR. JORDAN OFFICER is currently listed as active in the public NPI registry.
What is MR. JORDAN OFFICER's specialty?
The listing groups MR. JORDAN OFFICER with Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
What address line appears for MR. JORDAN OFFICER?
MR. JORDAN OFFICER's geographic hint is West Des Moines, Iowa in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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