Individual provider Active NPI

Michael J Jordan, DPM

  • Primary Podiatric Medicine Podiatrist
  • Spartanburg, SC
National Provider Identifier
1295724839
Registry record updated Oct 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
525 Issued in SC
Practice address
1399 John B White Sr Blvd
Spartanburg, SC 29306-3911
Phone
(864) 595-9300
Fax
(864) 595-9400
NPI assigned
Oct 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X 525 SC Primary
Foot Surgery Podiatrist 213ES0131X 525 SC

Addresses

Primary practice location

1399 John B White Sr Blvd
Spartanburg, SC 29306-3911

Mailing address

1399 John B White Sr Blvd
Spartanburg, SC 29306-3911
Phone (864) 595-9300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101027000924 SC Practitioner - Podiatry 2062315880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Foot Care LLCGroup PAC ID 0547163362, 2 clinicians

Practice addresses (Care Compare)

1399 John B White Sr Blvd
Spartanburg, SC 29306-3911
Phone (864) 595-9300

Hospital & facility affiliations

  • Spartanburg Medical Center Hospital, Spartanburg, SC, CCN 420007

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue195
Removal of skin lesions99
Removal of nail tissue915
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
525SCMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Foot Care LLC Primary Podiatric Medicine CurrentSince Jul 3, 2000 Accepting new patients

Locations

1399 John B White SR Blvd
Spartanburg, SC 29306
Phone (864) 595-9300

Organizations & group practices 1

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 4

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": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383004800000",
    "number": "1295724839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1399 JOHN B WHITE SR BLVD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293063911",
            "telephone_number": "864-595-9300",
            "fax_number": "864-595-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1399 JOHN B WHITE SR BLVD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293063911",
            "telephone_number": "864-595-9300",
            "fax_number": "864-595-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2013-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "SC",
            "license": "525",
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "SC",
            "license": "525",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.