ANNABELLE JORDAN – Family Nurse Practitioner, NPI 1124579016

ANNABELLE JORDAN is a healthcare provider. based in Lubbock, Texas. specializing in Family Nurse Practitioner. They hold a License No. AP132237 (TX). The NPI Number for ANNABELLE JORDAN is 1124579016

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
ANNABELLE JORDAN
NPI
1124579016
Phone
(806) 725-5844
Address
3420 22ND PL
Enumeration Date
17 October 2016
Last Update Date
17 October 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8067258400
Graduation Year
2016 (10 years ago)
PAC ID
3779862412
Group Practice PAC ID
6901889393
Professional Enrollment ID
I20161121000290
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:9State licenses:1Digital endpointsOther names

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Provider Addresses for ANNABELLE JORDAN

  • 3420, 22nd Place, Lubbock, Lubbock County, Texas, 79410, United States

    LUBBOCK, TX 794101314

    Phone: (806) 725-5844

    Fax: (806) 723-6532

    Type: Mailing

  • Covenant Health Southwest Medical Park, 9812, Slide Road, Lubbock, Lubbock County, Texas, 79424, United States

    LUBBOCK, TX 794245781

    Phone: (806) 725-8690

    Fax: (806) 725-8691

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $34.

Total Amount is formed as General ($34) + Research ($0) + Ownership ($0) = $34.

Last reported payment date: 2024-03-07 • Largest payer in this snapshot: Corium, LLC ($20).

Total Amount

$34

General + Research + Ownership

Payments

3

Total payment records

General Amount

$34

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-03-07

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2016-11-21

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
I20161121000290INurse 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 79410)

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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: 6901889393View full group profile
NameSpecialtyState
Cardiovascular Disease (Cardiology)TX
U R O L O G YTX
-TX
Diagnostic RadiologyTX
Physician AssistantTX
Nurse PractitionerTX
N E U R O S U R G E R YTX
Orthopedic SurgeryTX
Nurse PractitionerTX
Nurse PractitionerTX

Reviews

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Frequently asked questions

Does ANNABELLE JORDAN share an NPI with anyone else?
NPI numbers are unique to each provider or organization — ANNABELLE JORDAN uses 1124579016.
Does CMS list ANNABELLE JORDAN as active?
Yes — ANNABELLE JORDAN is active in the NPI listing used on this page.
What healthcare role does ANNABELLE JORDAN hold?
Scheduling teams often label ANNABELLE JORDAN under Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is ANNABELLE JORDAN based?
ANNABELLE JORDAN is tied to Lubbock, Texas in the data we show; additional addresses may exist on the full record.
Why does ANNABELLE JORDAN have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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