Jordan Black, CPNP-PC
NPI 1902496540ActiveIndividual· Nurse Practitioner, Pediatrics· Town And Country, MO
Nurse Practitioner, Pediatrics (CPNP-PC) in Town And Country, Missouri, licensed in MO, with an NPI issued in January 2021. Enrolled in Medicare as order and referring only - nurse practitioner.
Overview
| NPI | 1902496540 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | CPNP-PC |
| Sole proprietor | No |
| NPI issued | Jan 18, 2021 |
| Last updated in NPPES | Jul 10, 2023 |
| Certified by provider | Jul 10, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Pediatrics Primary | 363LP0200X | 2020021017 | MO |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Order and Referring Only - Nurse Practitioner (MO) |
|---|
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records