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Derek R. Jordan

Counselor - Professional β€’ Milford, OH

Active NPI 1669911285 Individual Practitioner Male Practitioner Accepts Medicare assignment
Practice location in NPPES

25 Whitney Dr Ste 122
Milford, OH 451508400

Call 5139414999 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

25 Whitney Dr Ste 122

Milford, OH 451508400

Telephone 5139414999
Fax 5136940168
Organization at the Same NPPES Address or Phone

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 11 distinct additional practice-address records in Cincinnati, OH; Columbus, OH; Dayton, OH and 6 more. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

CMS Doctors and Clinicians lists 1 group name: Sunrise Treatment Center Llc. See the list

Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Medicare Profile & Education

Source: CMS Doctors and Clinicians National Downloadable File

Graduation Year

2016

Years since graduation

10 years (graduated 2016)

CMS Doctors and Clinicians data list 2016 as the year this clinician finished professional school.

What this does not show: Years since graduation

It is not the number of years in practice, and more years does not mean better care.

Source: CMS Doctors and Clinicians National Downloadable File.

NPI first issued

2017

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Accepts Medicare assignment

CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Derek Jordan has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Derek Jordan as eligible to order or refer Medicare Part B clinical laboratory and imaging services and durable medical equipment (DME) for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Milford and Ohio

13 active clinicians are listed under Counselor - Professional with a practice address in Milford, OH (6,790 in Ohio).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Milford

0% of these 13 clinicians have the CMS telehealth indicator.

23.1% of these 13 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-06-23
Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

License # reported to NPPES OH E.2303715-SUPV
Counselor - Addiction (Substance Use Disorder)

NUCC Taxonomy Code: 101YA0400X

License # reported to NPPES OH LICDC-CS.161401
Counselor - Professional

NUCC Taxonomy Code: 101YP2500X

License # reported to NPPES OH C.1600018
Counselor - Addiction (Substance Use Disorder)

NUCC Taxonomy Code: 101YA0400X

License # reported to NPPES OH LCDCII.121091
Counselor - Addiction (Substance Use Disorder)

NUCC Taxonomy Code: 101YA0400X

License # reported to NPPES OH LCDCIII.121091
Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: State Medical Board of Ohio.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid ID
0218756 (OH)

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - MENTAL HEALTH COUNSELOR

Medicare Enrollment ID

I20260113003277

Enrollment State Jurisdiction

OH

PECOS Control ID

2961988514

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Not Eligible
Power Mobility Devices (PMD) Not Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Medicare Group Practice Enrollments

Source: CMS Doctors and Clinicians National Downloadable File

Sunrise Treatment Center Llc

25 Whitney Dr, Milford, OH 451508400

Phone: 5139414999

Secondary Practice Locations

160 N Breiel Blvd

Middletown, OH 450423806

Phone: 5139414999

100 Highview Blvd

Columbus, OH 432076023

Phone: 5139414999

680 Northland Blvd Ste 200

Cincinnati, OH 452403248

Phone: 5139414999

1435 Cincinnati St

Dayton, OH 454174614

Phone: 5139414999

1421 Parker Ct

Springfield, OH 455042855

Phone: 5139414999

6460 Harrison Ave Ste 200

Cincinnati, OH 452477958

Phone: 5139414999

1907 11th St

Portsmouth, OH 456624531

Phone: 5139414999

1718 Central Pkwy

Cincinnati, OH 452142355

Phone: 5139414999

7075 Industrial Rd Ste A

Florence, KY 410423053

Phone: 5139414999

1130 Garbry Rd

Piqua, OH 453568217

Phone: 5139414999

247 Cic Blvd

West Union, OH 456937512

Phone: 5139414999

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

6 listed
Christopher Aviles

Family Medicine

NPI 1265521066
Patti Ellison

Nurse Practitioner

NPI 1144260035
Arshad Javed

Internal Medicine

NPI 1306895842
Stacey Poe

Nurse Practitioner - Family

NPI 1285024588
Julie Schulkers

Nurse Practitioner - Family

NPI 1235659194
Amanda Wallace

Nurse Practitioner - Family

NPI 1154844041

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

17 Historical Events
πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) June 23, 2026

Counselor (license number reported to NPPES: OH LICDC-CS.161401)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) June 28, 2023

Counselor (license number reported to NPPES: OH LCDCIII.121091)

πŸ“
Updated Practice Location April 20, 2023

Registered at 25 WHITNEY DR STE 122, MILFORD, OH 451508400 (Tel: 5139414999)

πŸ“
Updated Business Mailing Address April 20, 2023

Registered at 6460 HARRISON AVE STE 200, CINCINNATI, OH 452477958 (Tel: 5139414999)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) March 20, 2023

Counselor (license number reported to NPPES: OH C.1600018)

βœ…
NPI Profile Active November 16, 2017

NPI status registered as active in NPPES database

πŸ“
Updated Practice Location November 16, 2017

Registered at 25 WHITNEY DRIVE, SUITE 122, MILFORD, OH 45150 (Tel: 5137539964)

πŸ“
Updated Business Mailing Address November 16, 2017

Registered at 25 WHITNEY DRIVE, SUITE 122, MILFORD, OH 45150 (Tel: 5137539964)

πŸ‘€
Provider Name / Credentials Updated November 16, 2017

Recorded as DEREK JORDAN

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) November 16, 2017

Counselor (license number reported to NPPES: OH C.1600018)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) November 16, 2017

Counselor (license number reported to NPPES: OH LCDCIII.121091)

βœ…
NPI Profile Active February 15, 2017

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) February 15, 2017

Registered at 1020 JEFFERSON ST, GREENFIELD, OH 451238319 (Tel: 9379811911)

πŸ“
Business Mailing Address (Initial Record) February 15, 2017

Registered at 111 W WATER ST, CHILLICOTHE, OH 456012452

πŸ‘€
Provider Name / Credentials (Initial Record) February 15, 2017

Recorded as DEREK JORDAN

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) February 15, 2017

Counselor (license number reported to NPPES: OH LCDCIII.121091)

🟒
Initial NPI Registration & Enumeration February 15, 2017

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1669911285
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 15, 2017
Last Update: June 23, 2026
Sole Proprietor: Yes

Mailing Address

6460 Harrison Ave Ste 200

Cincinnati, OH 452477958

Phone: 5139414999

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.