NPIMap

Individual provider Active NPI

Michael R Jordan, M.D.

  • Family Medicine Physician
  • Lee, NH
National Provider Identifier
1669817821
Registry record updated Mar 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
17702 Issued in NH
Practice address
65 Calef Hwy Ste 200
Lee, NH 03861-6703
Phone
(603) 868-3300
NPI assigned
May 1, 2013
Last updated
Mar 16, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 17702 NH Primary

Addresses

Primary practice location

65 Calef Hwy Ste 200
Lee, NH 03861-6703

Mailing address

PO Box 412503
Boston, MA 02241-2503
Phone (617) 726-3884

Other practice location 1

294 Daniel Webster Hwy
Dartmouth-Hitchcock Clinic/Family Medicine
Merrimack, NH 03054-4474
Phone (603) 440-7722

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160831001521 NH Practitioner - Family Practice 9234357724 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

65 Calef Hwy
Suite 200
Lee, NH 03861-6703
Phone (603) 868-3300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Wentworth Douglass Physician Corporation CurrentSince Mar 1, 2021 Accepting new patients
Wentworth Douglass Physician Corporation Family Medicine CurrentSince Mar 1, 2021 Accepting new patients
Wentworth Douglass Hospital Current Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Aug 15, 2016 Accepting new patients
Westchester Neurological Consultant PC Past Accepting new patients

Locations

8 Century Pines Dr
Ste 2
Barrington, NH 03825
Phone (603) 664-2135

789 Central Ave
Dover, NH 03820
Phone (603) 740-2832

36 Madbury Rd
Durham, NH 03824
Phone (603) 659-0901

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

65 Calef Hwy
Ste 200
Lee, NH 03861
Phone (603) 868-3300

294 Daniel Webster Hwy
Merrimack, NH 03054
Phone (603) 424-4713

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • Direct secure messaging: jordan.michael.wdh@direct.partners.masshiway.net

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1367366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1669817821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022412503",
            "telephone_number": "617-726-3884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 CALEF HWY STE 200",
            "city": "LEE",
            "state": "NH",
            "postal_code": "038616703",
            "telephone_number": "603-868-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "294 Daniel Webster Hwy",
            "address_2": "Dartmouth-Hitchcock Clinic/Family Medicine",
            "address_purpose": "LOCATION",
            "city": "Merrimack",
            "state": "NH",
            "postal_code": "030544474",
            "country_code": "US",
            "telephone_number": "603-440-7722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-01",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NH",
            "license": "17702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lee, NH

Sources for this page

Verify at the official NPI Registry.