Kelly Jordan, M.D.
Kelly Jordan, M.D. is a Pediatric Critical Care Medicine Physician in Oakland, CA, registered under NPI 1083060396. This provider registers 3 separate taxonomy codes, which usually means they practise across more than one recognised specialty. NPPES records them as a sole proprietor, meaning the practice is not incorporated as a separate legal entity.
Getting there
The practice address on file is 747 52ND ST, Oakland, CA 94609. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| MD60945855 | WA | Pediatric Critical Care Medicine Physician primary |
| MD60945855 | WA | Pediatrics Physician |
| 333542 | LA | Pediatric Critical Care Medicine Physician |
Licences are recorded in 2 states: WA, LA. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.
- Status
- Approved
- Provider type
- Practitioner - Pediatric Medicine
- PAC ID
- 8123402898
Medicare enrolment is recorded as approved under the provider type Practitioner - Pediatric Medicine. This means the provider is enrolled to bill Medicare, though it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
Licensed in 2 states
This provider holds licences in 2 states: Louisiana and Washington. Multi-state licensure often means the provider works near a state border, covers more than one office, or delivers care by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.
- Licence
- MD60945855
- Specialty
- Pediatric Critical Care Medicine…
Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.
What Pediatric Critical Care Medicine covers
A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. NUCC Health Care Provider Taxonomy, code 2080P0203X
All registered taxonomy codes
This provider registers 4 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 2080P0203X | Pediatric Critical Care Medicine Physician Pediatric Critical Care Medicine | MD60945855 | WA | primary |
| 208000000X | Pediatrics Physician | MD60945855 | WA | |
| 2080P0203X | Pediatric Critical Care Medicine Physician Pediatric Critical Care Medicine | 333542 | LA | |
| 390200000X | Student in an Organized Health Care Education/Training Program | — | — |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1083060396 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | May 5, 2016 |
| Last updated | Dec 20, 2022 |
| Status | Active |
| Sole proprietor | Yes |
| Credential | M.D. |
| Practice address |
747 52ND ST Oakland, CA 94609 (510) 428-3331 |
| Mailing address |
3261 FRANKLIN AVE E APT 7 Seattle, WA 98102 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 0 | 8 | 3 | 0 | 6 | 0 | 3 | 9 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 0 | 7 | 3 | 0 | 6 | 0 | 3 | 9 |
Sum = 54 · next multiple of 10 = 60 · check digit = 6 · actual last digit = 6
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.