William J Jordan, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601001389 Issued in MI

Practice address

839 S Putnam St
Williamston, MI 48895-1623

Phone

(517) 655-3515

Fax

(855) 476-0189

NPI assigned

Oct 20, 2006

Last updated

Jun 20, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560988800000",
    "number": "1144302803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5525 S MARTIN LUTHER KING JR BLVD",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489113546",
            "telephone_number": "517-394-3175",
            "fax_number": "517-394-7453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "839 S PUTNAM ST",
            "city": "WILLIAMSTON",
            "state": "MI",
            "postal_code": "488951623",
            "telephone_number": "517-655-3515",
            "fax_number": "855-476-0189"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5525 S Martin Luther King Jr Blvd",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489113546",
            "country_code": "US",
            "telephone_number": "517-394-3175",
            "fax_number": "517-394-7453",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2019-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601001389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1153313120",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PLUS BLUE-MEDICARE ADVANTAGE",
            "identifier": "0N61290008",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Williamston, MI
• Providers in Williamston, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2019; 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.