Individual provider Active NPI

Jordan Nicole Woodman, AU.D.

  • Audiologist
  • Macomb, MI
National Provider Identifier
1457044562
Registry record updated Jun 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
1601001116 Issued in MI
Practice address
17900 23 Mile Rd Ste 201
Macomb, MI 48044-1161
Phone
(586) 263-7601
NPI assigned
Jun 2, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 1601001116 MI Primary

Addresses

Primary practice location

17900 23 Mile Rd Ste 201
Macomb, MI 48044-1161

Mailing address

17900 23 Mile Rd Ste 201
Macomb, MI 48044-1161
Phone (586) 263-7601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230613001355 MI Practitioner - Qualified Audiologist 8527425164 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Central Michigan College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health St. John HospitalGroup PAC ID 3173424082, 332 clinicians

Practice addresses (Care Compare)

17900 23 Mile Rd
Macomb, MI 48044-1161
Phone (586) 263-7400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital Current Accepting new patients
Henry Ford Health St. John Hospital CurrentSince Jun 2, 2023 Accepting new patients
Henry Ford Health St. John Hospital CurrentSince Jun 2, 2023 Accepting new patients

Locations

17770 Mack Ave
Grosse Pointe Shores, MI 48230
Phone (313) 882-1731

17900 23 Mile Rd
Ste 203
Macomb, MI 48044
Phone (586) 263-7400

21000 E 12 Mile Rd
Ste 111
St Clr Shores, MI 48081
Phone (586) 779-7610

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.

NPI Registry JSON

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

{
    "created_epoch": "1685664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1457044562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17900 23 MILE RD STE 201",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480441161",
            "telephone_number": "586-263-7601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17900 23 MILE RD STE 201",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480441161",
            "telephone_number": "586-263-7601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODMAN",
        "first_name": "JORDAN",
        "middle_name": "NICOLE",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-02",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MI",
            "license": "1601001116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macomb, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.