Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1255857421 Individual Practitioner Female Practitioner

Blakley E Jordan , APRN

Nurse Practitioner - Pediatrics • Dayton, OH

Professional Overview & Biography Verified Profile Summary

Blakley Jordan, APRN is a registered healthcare professional specializing in Nurse Practitioner - Pediatrics in Dayton, OH. Practice services are available at 1 CHILDRENS PLZ under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1 Childrens Plz

Dayton, OH 454041873

Telephone 9376414762
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner - Pediatrics in Dayton, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 12.0 Yrs
State Avg: 12.0 Yrs
Regional Practice Density
58 Specialists

Practicing in Dayton, OH (1102 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-10-31
Nurse Practitioner - Pediatrics Primary Specialty

NUCC Taxonomy Code: 363LP0200X

State License OH 026091

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
0480186 (OH)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Hemanth Lingadevaru , MD, MPH, FAAP

Pediatrics - Pediatric Critical Care Medicine

NPI 1003018425

Doctor of Medicine (M.D.), Master of Public Health, FAAP

Dr. Tanya Paul , MD

Pediatrics - Pediatric Emergency Medicine

NPI 1003369331

Doctor of Medicine (M.D.)

Nicole Scott

Physician Assistant

NPI 1003408238
Cody Mcmillan

Physician Assistant

NPI 1003538299
Tania Montenegro , MS, MPH

Genetic Counselor, MS

NPI 1003622473

Master of Science, Master of Public Health

Faith Callif-Daley , MS

Genetic Counselor, MS

NPI 1003985946

Master of Science

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

14 Historical Events
📍
Updated Business Mailing Address October 31, 2024

Registered at PO BOX 933432, CLEVELAND, OH 441930039 (Tel: 9376414000)

👤
Provider Name / Credentials Updated October 31, 2024

Recorded as BLAKLEY JORDAN, APRN

📍
Updated Practice Location March 23, 2022

Registered at 1 CHILDRENS PLZ, DAYTON, OH 454041873 (Tel: 9376414762)

📍
Updated Business Mailing Address March 23, 2022

Registered at 1 CHILDRENS PLZ, DAYTON, OH 454041873

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 23, 2022

Nurse Practitioner (License #026091 in OH)

📍
Updated Practice Location July 26, 2018

Registered at 411 E CHESTNUT ST, LOUISVILLE, KY 40202 (Tel: 5025883440)

📍
Updated Business Mailing Address July 26, 2018

Registered at PO BOX 909, LOUISVILLE, KY 402010909 (Tel: 5025880325)

👤
Provider Name / Credentials Updated July 26, 2018

Recorded as BLAKLEY HACKMAN, APRN

NPI Profile Active August 18, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location August 18, 2017

Registered at 3015 WILSON AVE, LOUISVILLE, KY 402111969 (Tel: (502) 774-4401)

📍
Updated Business Mailing Address August 18, 2017

Registered at 3015 WILSON AVE, LOUISVILLE, KY 402111969 (Tel: 5027744401)

👤
Provider Name / Credentials Updated August 18, 2017

Recorded as BLAKLEY HACKMAN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 18, 2017

Nurse Practitioner (License #3011360 in KY)

🟢
Initial NPI Registration & Enumeration August 18, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1255857421
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 18, 2017
Last Update: October 31, 2024
Sole Proprietor: No

Mailing Address

Po Box 933432

Cleveland, OH 441930039

Phone: 9376414000

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.