Jared Emerson, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

5101029449 Issued in MI

Practice address

15777 Northline Rd Ste 200
Southgate, MI 48195-2354

Phone

(734) 246-8100

NPI assigned

May 10, 2023

Last updated

Oct 1, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

State licenses

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

{
    "created_epoch": "1683676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790812800000",
    "number": "1629768916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15777 NORTHLINE RD STE 200",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952354",
            "telephone_number": "734-246-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMERSON",
        "first_name": "JARED",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-10",
        "last_updated": "2026-10-01",
        "certification_date": "2026-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "5101029449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jemerson1232681@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "15777 Northline Rd Ste 200",
            "city": "Southgate",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481952354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Crystal Dawn Ellison
• James Ellsworth
• Elizabeth Elster
• Emily Elston, O.D
• Krishawn Emadamerho, OTR
• Malia Ann Emerson
• Sarah Emmerson, MA, LLP
• Emotional Comfortwear
• Engler and Kartha MD PLLC
• Engler PLLC

• Pediatrics Physician in Southgate, MI
• Providers in Southgate, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2026; 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.