Jordan Lawrence Gowman, DO
Individual provider Active NPI Emergency Medicine Physician · Muskegon, MI
NPI 1356901292 · NPPES record last updated Aug 29, 2023
Key facts
- NPI
- 1356901292
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 5101025957 (MI)
- Practice address
- 1500 E Sherman Blvd
Muskegon, MI 49444-1849 - Phone
- (616) 685-3500
- Fax
- (231) 652-1452
- NPI assigned
- Jun 13, 2019
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Hospital & facility affiliations 9
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Michigan State University College of Osteopathic Medicine, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lake Michigan Emergency Specialists, PLLC
Practice addresses (Care Compare)
72 S State St
Lakeshore Campus
Shelby, MI 49455-1228
Phone (231) 728-4601
Hospital & facility affiliations
- Trinity Health Muskegon Hospital
- Aspirus Ironwood Hospital
- Trinity Health Grand Haven Hospital
- Mercy Health Lakeshore Campus
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220628001231 | MI | Practitioner - Emergency Medicine | 4284013822 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5151013982 | MI | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aspirus Ironwood Hospital & Clinics, Inc. | Current | Accepting new patients | |
| Aspirus Ironwood Hospital & Clinics, Inc. | Current |
Accepting new patients | |
| Lake Michigan Emergency Specialists, PLLC | Emergency Medicine | Current |
Accepting new patients |
| Aspirus Ironwood Hospital & Clinics, Inc. | Current |
Accepting new patients |
Locations
29980 Network Pl
Chicago, IL 60673
N10561 Grandview Ln
Ironwood, MI 49938
Phone (906) 932-1500
N10565 Grandview Ln
Ironwood, MI 49938
Phone (906) 932-1500
1700 Clinton St
Muskegon, MI 49442
Phone (231) 726-3511
1500 E Sherman Blvd
Muskegon, MI 49444
Phone (231) 672-3027
72 S State St
Shelby, MI 49455
Phone (231) 728-4601
Interoperability endpoints
- jgowman42795@direct.trinity-health.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 5151013982 | MI | |
| Emergency Medicine Physician | 207P00000X | 5101025957 | MI | Yes |
Addresses
Primary practice location
1500 E Sherman Blvd
Muskegon, MI 49444-1849
Mailing address
1675 Leahy St Ste 315a
Muskegon, MI 49442-5543
Phone (231) 727-5244
Other providers in Muskegon, MI
- Julie Jeanne Gortsema
- Heidi Gossard
- Zachary Michael Gould
- Felina Goulet
- Jeffrey Donald Gowing
- Grace Solutions
- James Grace
- Brian David Gradwohl
- William Alex Grady
- Joseph Anthony Graftema
All providers in Muskegon, MI · Emergency Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 29, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.