Provider Demographics
NPI:1063837813
Name:CARTWRIGHT, JORDAN (PA-C)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:CARTWRIGHT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 GREAT CIRCLE RD
Mailing Address - Street 2:STE. 200
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1317
Mailing Address - Country:US
Mailing Address - Phone:615-329-7878
Mailing Address - Fax:615-329-7899
Practice Address - Street 1:2010 CHURCH ST
Practice Address - Street 2:STE. 700
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2012
Practice Address - Country:US
Practice Address - Phone:615-329-7878
Practice Address - Fax:615-329-7899
Is Sole Proprietor?:No
Enumeration Date:2014-03-03
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2775363A00000X, 363AS0400X
TX363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNAPPLIED FOROtherBCBST
TNAPPLIED FOROtherRR MEDICARE
TNAPPLIED FORMedicaid
TNAPPLIED FOROtherBCBST