Active NPI
Jordan Maxey
- Physical Therapist
- Niles, MI
National Provider Identifier
1033945928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 905 N Front St
Niles, MI 49120-1677 - Phone
- (269) 683-6800
- NPI assigned
- Sep 9, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501303503 | MI | |
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
905 N Front St
Niles, MI 49120-1677
Mailing address
905 N Front St
Niles, MI 49120-1677
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501303503 | MI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeland Hospitals at Niles and St Joseph, Inc | Past | Accepting new patients | |
| Lakeland Hospital at Niles and St Joseph, Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Rehabilitation Hospital Unit
- Saint Joseph, MI
- NPI 1760589956
-
- Community Health Clinic/Center
- Saint Joseph, MI
- NPI 1184513731
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1725840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725840000000",
"number": "1033945928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "905 N FRONT ST",
"city": "NILES",
"state": "MI",
"postal_code": "491201677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "905 N FRONT ST",
"city": "NILES",
"state": "MI",
"postal_code": "491201677",
"telephone_number": "269-683-6800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAXEY",
"first_name": "JORDAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-09",
"last_updated": "2024-09-09",
"certification_date": "2024-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501303503",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Niles, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.