Myechia Minter-Jordan, M.D., MBA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

230963 Issued in MA

Practice address

55 Dimock St
Roxbury, MA 02119-1029

Phone

(617) 442-8800

NPI assigned

May 10, 2006

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Business Administration, Doctor of Medicine

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275350400000",
    "number": "1497705628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 DIMOCK ST",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021191029",
            "telephone_number": "617-442-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 DIMOCK ST",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021191029",
            "telephone_number": "617-442-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINTER-JORDAN",
        "first_name": "MYECHIA",
        "name_prefix": "Dr.",
        "credential": "M.D., MBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2010-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "230963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "803402800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric Andrew Meyers
• Eleonora Nestora Michael
• Sajata Mikell
• Millenium Management Inc
• Nia Millington
• Dulcelina Daveiga Miranda
• Tindi Miranda
• Catherine R. Mitchell
• Juliet Mitchell
• Rachel Mitchell

• Internal Medicine Physician in Roxbury, MA
• Providers in Roxbury, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.