Jordan T Boivin, MD

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

4301517677 Issued in MI

Practice address

2490 S 11TH St Ste 201
Kalamazoo, MI 49009-2175

Phone

(269) 343-1535

Fax

(269) 343-0418

NPI assigned

May 20, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Orthopedic SurgeryAlso: Sports Medicine

Education

Wright State University Boonshoft School of Medicine, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1589932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1346863750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380",
            "telephone_number": "269-552-2823",
            "fax_number": "269-552-2964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2490 S 11TH ST STE 201",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490092175",
            "telephone_number": "269-343-1535",
            "fax_number": "269-343-0418"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Oakland Dr",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490081282",
            "country_code": "US",
            "telephone_number": "269-337-4600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1021 Hill St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Three Rivers",
            "state": "MI",
            "postal_code": "490932744",
            "country_code": "US",
            "telephone_number": "269-858-3024",
            "fax_number": "269-273-9040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOIVIN",
        "first_name": "JORDAN",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-20",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MI",
            "license": "4301517677",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4351046936",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346863750",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah Bohm, N.P.
• Taeler Bohm
• Bryon A Bohnet, OD
• Trent Bohrmann
• Amy Boileau, COUNSELOR
• Julie Ann Bol, CCC-SLP
• Kayla Bolden
• Margaret Ann Boles, R.N.
• Bryon David Boley, MD
• Karla S Bolkcom, M.A.

• Sports Medicine (Orthopaedic Surgery) Physician in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.