Individual provider Active NPI

Jordan Taylor, D.O.

  • Neurology Physician
  • Wyoming, MI
National Provider Identifier
1215147343
Registry record updated Dec 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
510101819 Issued in MI
Practice address
2122 Health Dr SW
Wyoming, MI 49519-9698
Phone
(616) 252-5790
Fax
(616) 252-5793
NPI assigned
May 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 510101819 MI Primary

Addresses

Primary practice location

2122 Health Dr SW
Wyoming, MI 49519-9698

Mailing address

5900 Byron Center Ave SW
Medical Adminiatration
Wyoming, MI 49519-9606
Phone (616) 252-3243

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101207000437 MI Practitioner - Neurology 7618164377 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Michigan State University College of Osteopathic Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metropolitan HospitalGroup PAC ID 5597651836, 421 clinicians

Practice addresses (Care Compare)

2122 Health Dr SW
Metro Health Infectious Disease
Wyoming, MI 49519-9698
Phone (616) 252-6050

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
510101819MIMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Hospital CurrentSince Jun 1, 2016 Accepting new patients
Metropolitan Hospital Past Accepting new patients
Pennant Physician Services Past Accepting new patients

Locations

4200 Division Ave N
Comstock Park, MI 49321
Phone (616) 252-1600

2122 Health Dr SW
Ste 160
Wyoming, MI 49519
Phone (616) 252-5220

5950 Metro Way SW
Wyoming, MI 49519
Phone (616) 252-8100

5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243

2122 Health Dr SW
Ste 230
Wyoming, MI 49519

2215 44th St SW
Ste 100
Wyoming, MI 49519
Phone (616) 252-8300

2122 Health Dr SW
Wyoming, MI 49519
Phone (616) 252-5950

Interoperability endpoints

  • Direct secure messaging: jtaylor27854@direct.metrohealth.net

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512691200000",
    "number": "1215147343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 BYRON CENTER AVE SW",
            "address_2": "MEDICAL ADMINIATRATION",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199606",
            "telephone_number": "616-252-3243",
            "fax_number": "616-252-0260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2122 HEALTH DR SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199698",
            "telephone_number": "616-252-5790",
            "fax_number": "616-252-5793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JORDAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2017-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "510101819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

Verify at the official NPI Registry.