Active NPI
Elizabeth Jordan, PH.D.
- Psychologist
- Ann Arbor, MI
National Provider Identifier
1043384027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301005287
- Practice address
- 201 E Liberty St
Suite 15
Ann Arbor, MI 48104-2118 - Phone
- (734) 662-9795
- Fax
- (734) 662-9795
- NPI assigned
- Nov 20, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301005287 | MI | Primary |
Addresses
Primary practice location
201 E Liberty St
Suite 15
Ann Arbor, MI 48104-2118
Mailing address
201 E Liberty St
Suite 15
Ann Arbor, MI 48104-2118
Phone (734) 662-9795
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0 H1 1383 | Other | BLUE CROSS PROVIDER CODE |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301005287 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043384027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 E LIBERTY ST",
"address_2": "SUITE 15",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481042118",
"telephone_number": "734-662-9795",
"fax_number": "734-662-9795"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 E LIBERTY ST",
"address_2": "SUITE 15",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481042118",
"telephone_number": "734-662-9795",
"fax_number": "734-662-9795"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301005287",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PROVIDER CODE",
"identifier": "0 H1 1383",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.