Active NPI
Jordan Young
- Other Technician
- Hartland, MI
National Provider Identifier
1154773414
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- License
- Y520439676427
- Practice address
- 2331 Peppermill CT
Hartland, MI 48353-3146 - Phone
- (248) 707-4796
- NPI assigned
- Jul 11, 2016
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Other Technician | 247200000X | Y520439676427 | MI | Primary |
Addresses
Primary practice location
2331 Peppermill CT
Hartland, MI 48353-3146
Mailing address
2331 Peppermill CT
Hartland, MI 48353-3146
Phone (248) 707-4796
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| Y520439676427 | MI | MD | Other Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468195200000",
"number": "1154773414",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2331 PEPPERMILL CT",
"city": "HARTLAND",
"state": "MI",
"postal_code": "483533146",
"telephone_number": "248-707-4796"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2331 PEPPERMILL CT",
"city": "HARTLAND",
"state": "MI",
"postal_code": "483533146",
"telephone_number": "248-707-4796"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "JORDAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-11",
"last_updated": "2016-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "MI",
"license": "Y520439676427",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hartland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.