Michell M Jordan, DNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R197956 Issued in MD

Practice address

410 Lockerman St
Denton, MD 21629-1048

Phone

(410) 479-3075

Fax

(833) 914-0407

NPI assigned

Oct 19, 2006

Last updated

Jun 28, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Choptank Community Health System IncGroup PAC ID 0648189274, 40 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michell.jordan.1@20853.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Choptank Community Health System Inc

  • Federally Qualified Health Center (FQHC)
  • Denton, MD
  • NPI 1356388599
  Medicare reassignment Care Compare group NPD
• University of Maryland Community Medical Group, Inc.

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1477530624
  Medicare reassignment
• Choptank Community Health System Inc

  dba Federalsburg Health Center

  • Federally Qualified Health Center (FQHC)
  • Federalsburg, MD
  • NPI 1306678537
  NPD

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1366524365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 LOCKERMAN ST",
            "city": "DENTON",
            "state": "MD",
            "postal_code": "216291048",
            "telephone_number": "410-479-3075",
            "fax_number": "833-914-0407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 LOCKERMAN ST",
            "city": "DENTON",
            "state": "MD",
            "postal_code": "216291048",
            "telephone_number": "410-479-3075",
            "fax_number": "833-914-0407"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2540 Centreville Rd",
            "address_purpose": "LOCATION",
            "city": "Centreville",
            "state": "MD",
            "postal_code": "21617",
            "country_code": "US",
            "telephone_number": "411-758-4432",
            "fax_number": "410-758-1938",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "MICHELL",
        "middle_name": "M",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R197956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBD FEDERAL",
            "identifier": "68320014",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "8355618",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "0009541449",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "049008300",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MD",
            "identifier": "97602401",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leslie Michelle Jefferson
• Christian Edward Jensen, MD
• Alexa C Jester, LMSW
• April Jones
• Victoria D Jones, PTA
• Susan P Jordan, PTA
• Kathleen Ann Judy, M.S. CCC/SLP
• Ebai Helene Etta Kamsu Nasah
• Joanna Rose Katherman, LGSW
• Shayna Marie Kerr, NP

• Nurse Practitioner in Denton, MD
• Providers in Denton, MD by specialty
• Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; 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.