DANIELLE RESHONDA JORDAN (PMHNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1174495980

DANIELLE RESHONDA JORDAN (PMHNP) is a healthcare provider. based in North las vegas, Nevada. specializing in NURSE PRACTITIONER. They hold the professional credentials PMHNP. They hold a License No. 816581 (NV). The NPI Number for DANIELLE RESHONDA JORDAN (PMHNP) is 1174495980

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
DANIELLE RESHONDA JORDAN (PMHNP)
NPI
1174495980
Phone
(708) 476-3858
Address
4245 VENUS FALLS AVE
Enumeration Date
22 September 2025
Last Update Date
22 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7026256455
Graduation Year
2025 (1 year ago)
PAC ID
9931686219
Group Practice PAC ID
3173031606
Professional Enrollment ID
I20260116001399
Address ID
NV89183XXXXLAXXXXXXXXXX00
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

2,947 NURSE PRACTITIONER in NV

Provider Addresses for DANIELLE RESHONDA JORDAN (PMHNP)

  • 4245 VENUS FALLS AVE

    NORTH LAS VEGAS, NV 890845109

    Phone: (708) 476-3858

    Type: Mailing

  • 2121 E FLAMINGO RD STE 202

    LAS VEGAS, NV 891195124

    Phone: (702) 405-9819

    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: 2026-01-16

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
I20260116001399INurse PractitionerNVTBD

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 89084)

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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: 3173031606View full group profile
NameSpecialtyState
Nurse PractitionerNV
Nurse PractitionerUT
Nurse PractitionerNV

Reviews

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Frequently asked questions

Does DANIELLE RESHONDA JORDAN (PMHNP) have a public NPI I can cite?
Public records show DANIELLE RESHONDA JORDAN (PMHNP) under NPI 1174495980.
Does the public listing show DANIELLE RESHONDA JORDAN (PMHNP) as active?
DANIELLE RESHONDA JORDAN (PMHNP)'s NPI record reflects an active status in NPPES.
What type of care does DANIELLE RESHONDA JORDAN (PMHNP) provide?
DANIELLE RESHONDA JORDAN (PMHNP)'s profile centers on Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is DANIELLE RESHONDA JORDAN (PMHNP) tied to North Las Vegas, Nevada?
If you are local to North Las Vegas, Nevada, DANIELLE RESHONDA JORDAN (PMHNP) may be relevant to your search.
Why is information missing for DANIELLE RESHONDA JORDAN (PMHNP)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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