Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Blake Nelson Jordan, PA-C

Individual provider Medical Physician Assistant · NPI 1740159060

Blake Nelson Jordan, PA-C is a Physician Assistant in Park City, Utah. Qualified in 2025, 1 year ago. Practices with Stat MD LLC, a 2-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
1
Licensed in
UT
In the registry since
2025
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

1784 Uinta Way Ste E
Park City, UT 84098-7669
Phone: (435) 604-0160
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X (UT)

Record details

NPI number1740159060
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedNovember 4, 2025
Last updated in NPPESNovember 4, 2025
Certification dateNovember 4, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Stat Md Llc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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