MR. JORDAN JAMES RICKWA (PA-C) – Physician Assistant, NPI 1689411803

MR. JORDAN JAMES RICKWA (PA-C) is a healthcare provider. based in Thompsons station, Tennessee. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 6772 (TN). The NPI Number for MR. JORDAN JAMES RICKWA (PA-C) is 1689411803

Main info

Male
1 Year Of Experience
Accepts Medicare Assignment
Name
MR. JORDAN JAMES RICKWA (PA-C)
NPI
1689411803
Phone
(615) 603-1654
Address
504 COPPERTOP CT
Enumeration Date
15 July 2024
Last Update Date
20 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6154721550
Graduation Year
2025 (1 year ago)
PAC ID
2668962515
Group Practice PAC ID
9436336047
Professional Enrollment ID
I20251107003652
Address ID
TN370670000FR155XXRDXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness85
Years active:1State licenses:1Digital endpointsOther names

3,118 PHYSICIAN ASSISTANT in TN

Provider Addresses for MR. JORDAN JAMES RICKWA (PA-C)

  • 504 COPPERTOP CT

    THOMPSONS STATION, TN 371792905

    Phone: (615) 603-1654

    Type: Mailing

  • 155 COVEY DR STE 100

    FRANKLIN, TN 370676019

    Phone: (615) 472-1550

    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: 2025-11-07

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
I20251107003652IPhysician AssistantTNTBD

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 37179)

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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: 9436336047View full group profile
NameSpecialtyState
Physician AssistantAZ
Physician AssistantTN
Physician AssistantTN
Nurse PractitionerTN
Physician AssistantTN
-TN
Physician AssistantTN
Physician AssistantKY
Physician AssistantTN
-TN

Reviews

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Frequently asked questions

What federal number belongs to MR. JORDAN JAMES RICKWA (PA-C)?
The federal identifier for MR. JORDAN JAMES RICKWA (PA-C) is NPI 1689411803.
Is MR. JORDAN JAMES RICKWA (PA-C)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does MR. JORDAN JAMES RICKWA (PA-C) list a primary specialty?
If you are matching referrals, note Physician Assistant for MR. JORDAN JAMES RICKWA (PA-C). Clinical services aligned with this taxonomy classification.
What location metadata exists for MR. JORDAN JAMES RICKWA (PA-C)?
The page summarizes Thompsons Station, Tennessee for MR. JORDAN JAMES RICKWA (PA-C); expand the address list for detail.
Is MR. JORDAN JAMES RICKWA (PA-C) a real provider?
This page reflects official NPPES data for NPI 1689411803. Always confirm identity and privileges with the practice and licensing boards.

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