Active NPI
Sherron Damien Jordan
- Technician/Technologist
- Dearborn, MI
National Provider Identifier
1467169201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Technician/Technologist
- Practice address
- 19855 Outer Dr Ste 110
Dearborn, MI 48124-2022 - Phone
- (313) 406-5056
- NPI assigned
- Nov 1, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Technician/Technologist | 156F00000X | Primary |
Addresses
Primary practice location
19855 Outer Dr Ste 110
Dearborn, MI 48124-2022
Mailing address
19855 Outer Dr Ste 110
Dearborn, MI 48124-2022
Phone (313) 406-5056
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667260800000",
"number": "1467169201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19855 OUTER DR STE 110",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481242022",
"telephone_number": "313-406-5056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19855 OUTER DR STE 110",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481242022",
"telephone_number": "313-406-5056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "SHERRON",
"middle_name": "DAMIEN",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-11-01",
"last_updated": "2022-11-01",
"certification_date": "2022-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "156F00000X",
"taxonomy_group": "",
"desc": "Technician/Technologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.