Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jordan Robert Fenton, FNP-C

Individual provider Family Nurse Practitioner · NPI 1912491374

Jordan Robert Fenton, FNP-C is a Nurse Practitioner in Canton, New York. Qualified in 2018, 8 years ago. Practices with Healey Medical Practice, PLLC, a 4-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
8
Licensed in
NY
In the registry since
2018
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

25 Park St
Canton, NY 13617-1265
Phone: (315) 379-9158
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 343107 (NY)

Record details

NPI number1912491374
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP-C
Sole proprietorNo
NPI enumeratedJune 19, 2018
Last updated in NPPESOctober 11, 2023
Certification dateOctober 11, 2023

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Healey Medical Practice, Pllc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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