ANTIONETTE JORDAN – Nurse Practitioner, NPI 1275249237
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
7,017 NURSE PRACTITIONER in MO
Provider Addresses for ANTIONETTE JORDAN
PO BOX 802841
KANSAS CITY, MO 641802841
Phone: (314) 842-9669
Fax: (314) 842-1017
Type: Mailing
10004 KENNERLY RD STE 374B
SAINT LOUIS, MO 631282178
Phone: (314) 842-9669
Fax: (314) 842-1017
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 50 Open Payments records for all available years, with a total value of $939.
Total Amount is formed as General ($939) + Research ($0) + Ownership ($0) = $939.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: Otsuka America Pharmaceutical, Inc. ($146).
Total Amount
$939
General + Research + Ownership
Payments
50
Total payment records
General Amount
$939
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-18
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2023-02-22
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 |
|---|---|---|---|---|
| I20230222000310 | I | Nurse Practitioner | MO | 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 |
|---|---|---|---|---|
| 90961 | Dialysis services, 2-3 physician visits per month (20 years or older) | 13 | 11 | $0 |
Insurance plans in this area (ZIP 64180)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine, Nephrology | IL | |
| N E P H R O L O G Y | MO | |
| Nurse Practitioner | MO | |
| N E P H R O L O G Y | MO | |
| Emergency Medicine, Internal Medicine | MO | |
| Nurse Practitioner | MO | |
| N E P H R O L O G Y | MO |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.