JORDAN B. RICHARDSON (FNP-C) – Family Nurse Practitioner, NPI 1043707748

JORDAN B. RICHARDSON (FNP-C) is a healthcare provider. based in Longview, Texas. specializing in Family Nurse Practitioner. They hold the professional credentials FNP-C. They hold a License No. AP137083 (TX). The NPI Number for JORDAN B. RICHARDSON (FNP-C) is 1043707748

Main info

Female
Sole Proprietor
9 Years Of Experience
Accepts Medicare Assignment
Name
JORDAN B. RICHARDSON (FNP-C)
NPI
1043707748
Phone
(903) 753-2322
Address
2 DOCTOR CIR
Enumeration Date
18 April 2018
Last Update Date
18 April 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9035318950
Graduation Year
2017 (9 years ago)
PAC ID
3476818659
Group Practice PAC ID
4486915600
Professional Enrollment ID
I20180518000892
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:8State licenses:1Digital endpointsOther names

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Provider Addresses for JORDAN B. RICHARDSON (FNP-C)

  • Longview Spine & Sports Medicine, 2, Doctor Circle, Longview, Gregg County, Texas, 75605, United States

    LONGVIEW, TX 756055050

    Phone: (903) 753-2322

    Fax: (903) 234-2979

    Mailing address matches the actual address.

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: 2018-05-18

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
I20180518000892INurse PractitionerTXTBD

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 75605)

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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: 4486915600View full group profile

Reviews

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Frequently asked questions

What number should I use to identify JORDAN B. RICHARDSON (FNP-C) for billing?
Administrative and clinical systems typically use NPI 1043707748 for JORDAN B. RICHARDSON (FNP-C).
Quick check: is JORDAN B. RICHARDSON (FNP-C) active?
Public NPPES data shows JORDAN B. RICHARDSON (FNP-C) with an active NPI status right now.
How should patients interpret JORDAN B. RICHARDSON (FNP-C)'s specialty?
The extract shows Family Nurse Practitioner for JORDAN B. RICHARDSON (FNP-C). Clinical services aligned with this taxonomy classification.
What geographic area is tied to JORDAN B. RICHARDSON (FNP-C)?
JORDAN B. RICHARDSON (FNP-C) is associated with Longview, Texas in the same public data insurers reference.
Can I export JORDAN B. RICHARDSON (FNP-C)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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