Nigel Wayne Jordon

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

AS410311728 Issued in MI

Practice address

2215 Bentbrook CT SE
Kentwood, MI 49508-6313

Phone

(616) 246-1144

NPI assigned

Dec 28, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1640649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1043970320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3287 STORMY CREEK DR SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495127902",
            "telephone_number": "616-551-1452",
            "fax_number": "616-710-5769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 BENTBROOK CT SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495086313",
            "telephone_number": "616-246-1144"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3287 Stormy Creek Dr SE",
            "address_purpose": "LOCATION",
            "city": "Kentwood",
            "state": "MI",
            "postal_code": "495127902",
            "country_code": "US",
            "telephone_number": "616-551-1452",
            "fax_number": "616-710-5769",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORDON",
        "first_name": "NIGEL",
        "middle_name": "WAYNE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-28",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "MI",
            "license": "AS410409367",
            "primary": false
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "MI",
            "license": "AS410311728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James R Jokerst, M.D.
• Laneisha M Jones
• Megan Renae Jonker
• Ariauna Marie Jordan, BEHAVIOR TECHNICIAN
• Heather Lynn Jordan, PA-C
• Joseph a. Rossi, D.D.S., P.C.
• Mira Charlotte Jourdan, PHD
• Kabafusion of Mi, LLC
• Gabriela Kabandana
• Olivia M Kaercher

• Assisted Living Facility (Mental Illness) in Kentwood, MI
• Providers in Kentwood, MI by specialty
• Assisted Living Facility (Mental Illness) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.