Individual provider Active NPI

Janet Gilchrist Jordan, MA LLP

  • Psychologist
  • Troy, MI
National Provider Identifier
1043413164
Registry record updated Mar 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301013844 Issued in MI
Practice address
2075 W Big Beaver Rd
Suite 520
Troy, MI 48084-3407
Phone
(248) 646-6659
NPI assigned
Jun 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301013844 MI Primary

Addresses

Primary practice location

2075 W Big Beaver Rd
Suite 520
Troy, MI 48084-3407

Mailing address

703 N Gainsborough Ave
Royal Oak, MI 48067-4223
Phone (248) 563-2290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110324000914 MI Practitioner - Clinical Psychologist 6305029562 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1475 Edgewood Blvd
Berkley, MI 48072-2132
Phone (248) 563-2290

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Janet Gilchrist Jordan PHD PLLC Psychologist CurrentSince Jan 2, 2012 Accepting new patients

Locations

628 E Parent Ave
Ste 109
Royal Oak, MI 48067
Phone (248) 563-2290

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238025600000",
    "number": "1043413164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 N GAINSBOROUGH AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480674223",
            "telephone_number": "248-563-2290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 W BIG BEAVER RD",
            "address_2": "SUITE 520",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480843407",
            "telephone_number": "248-646-6659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "JANET",
        "middle_name": "GILCHRIST",
        "name_prefix": "Dr.",
        "credential": "MA LLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2009-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301013844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.