Mary Chisholm Jordan, D.O.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

5101010084 Issued in MI

Practice address

44199 Dequindre Rd
Suite 415
Troy, MI 48085-1128

Phone

(248) 964-6061

Fax

(248) 964-6054

NPI assigned

Aug 7, 2008

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Beaumont Medical Group- Specialty Services

  • Surgery Physician
  • Royal Oak, MI
  • NPI 1578072906
  Medicare reassignment NPD
• Kristen Roy MD PLLC

  • Obstetrics & Gynecology Physician
  • Auburn Hills, MI
  • NPI 1801096474
  NPD (past)
• Mary C Jordan

  • Obstetrics & Gynecology Physician
  • Auburn Hills, MI
  • NPI 1609293349
  NPD (past)

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

{
    "created_epoch": "1218067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218067200000",
    "number": "1467618694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44199 DEQUINDRE RD",
            "address_2": "SUITE 415",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480851128",
            "telephone_number": "248-964-6061",
            "fax_number": "248-964-6054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44199 DEQUINDRE RD",
            "address_2": "SUITE 415",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480851128",
            "telephone_number": "248-964-6061",
            "fax_number": "248-964-6054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "MARY",
        "middle_name": "CHISHOLM",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-07",
        "last_updated": "2008-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "5101010084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Autumn Jordan, LLBSW
• Chenaull Van Jordan, N.P.
• Deja Montiana Amari Jordan
• Janet Gilchrist Jordan, MA LLP
• Karla Jordan, NP
• Paula M Jorne, PHD LPC
• Josina Jose
• Smitha Jose, NP
• Joseph a. Arends M.D. P.C.
• Joseph Advanced Facial Plastic Surgery, PLLC

• Obstetrics & Gynecology Physician in Troy, MI
• Providers in Troy, MI by specialty
• Obstetrics & Gynecology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.