Jordan Elizabeth Gardner, OTRL

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201009433 Issued in MI

Practice address

30821 Barrington St
Madison Heights, MI 48071-1871

Phone

(248) 291-5397

NPI assigned

May 16, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jordan Boulier Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1463356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1073960472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3135 PROFESSIONAL DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481045131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30821 BARRINGTON ST",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480711871",
            "telephone_number": "248-291-5397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "JORDAN",
        "middle_name": "ELIZABETH",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-16",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201009433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDAN",
            "last_name": "BOULIER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Renea Gailey
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• Sydney Gantz, M.S., BCBA
• Leanna Garbula
• Luis Alberto Garcia-Lopez, BA
• Sreekanth Gayam
• Daniel Eugene Geer, PT
• Ronald W Gellasch, CRNA
• Habib G Gennaoui, MD
• Gentle Dental John R PLLC

• Occupational Therapist in Madison Heights, MI
• Providers in Madison Heights, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2022; 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.