DOUGLAS R JORDAN (OD) – Optometrist, NPI 1790760197

DOUGLAS R JORDAN (OD) is a healthcare provider. based in Branson, Missouri. specializing in Optometrist. They hold the professional credentials OD. They hold a License No. T 03117 (MO). The NPI Number for DOUGLAS R JORDAN (OD) is 1790760197

Main info

Male
33 Years Of Experience
Accepts Medicare Assignment
Name
DOUGLAS R JORDAN (OD)
NPI
1790760197
Phone
(417) 334-0044
Address
915 STATE HWY 248 STE A
Enumeration Date
8 December 2005
Last Update Date
19 August 2021

Doctor Profile

Medical School Name
UNIVERSITY OF MISSOURI ST LOUIS - SCHOOL OF OPTOMETRY
Secondary Phone
4172552010
Graduation Year
1993 (33 years ago)
PAC ID
8729082052
Group Practice PAC ID
1557447935
Professional Enrollment ID
I20100910000895
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience73
Completeness75
Years active:20State licenses:2Digital endpointsOther names

Provider Addresses for DOUGLAS R JORDAN (OD)

  • 915 STATE HWY 248 STE A

    BRANSON, MO 656162030

    Phone: (417) 334-0044

    Type: Location

  • 3440, South National Avenue, Springfield, Greene County, Missouri, 65807, United States

    SPRINGFIELD, MO 65807

    Phone: (417) 886-5444

    Type: Mailing

  • 2943 HIGHWAY 62 W

    MOUNTAIN HOME, AR 726536535

    Phone: (870) 424-4900

    Fax: (870) 424-4979

    Type: Location

  • PO BOX 444

    MOUNTAIN HOME, AR 726540444

    Phone: (870) 424-4900

    Fax: (870) 424-4979

    Type: Mailing

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: 2020-08-17

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
I20200817001328IOptometryARTBD

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 65616)

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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: 1557447935View full group profile
NameSpecialtyState
O P T O M E T R YMO
O P T O M E T R YMO

Reviews

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Frequently asked questions

What is the standard ID for DOUGLAS R JORDAN (OD) in the U.S.?
In the U.S., DOUGLAS R JORDAN (OD) is identified by NPI 1790760197.
Is DOUGLAS R JORDAN (OD)'s NPI status active today?
Active status means DOUGLAS R JORDAN (OD)'s NPI record is not deactivated in the public file.
Which specialty label fits DOUGLAS R JORDAN (OD)?
NPPES ties DOUGLAS R JORDAN (OD) to Optometrist in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to DOUGLAS R JORDAN (OD)?
DOUGLAS R JORDAN (OD) is associated with Branson, Missouri in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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