Rebecca Jordan, LLP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301014655 Issued in MI

Practice address

8623 N Wayne Rd
Suite 310
Westland, MI 48185-1137

Phone

(734) 425-0636

NPI assigned

Oct 5, 2011

Last updated

Aug 11, 2016By the provider in NPPES

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

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pure Psychiatry of Michigan PLLC

  • Physician Assistant
  • Wayne, MI
  • NPI 1831701671
  Medicare reassignment NPD

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

{
    "created_epoch": "1317772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470873600000",
    "number": "1720362049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8623 N WAYNE RD",
            "address_2": "SUITE 310",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481851137",
            "telephone_number": "734-425-0636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8623 N WAYNE RD",
            "address_2": "SUITE 310",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481851137",
            "telephone_number": "734-425-0636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "REBECCA",
        "credential": "LLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-05",
        "last_updated": "2016-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301014655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keshia Jones
• Lacie Jones
• Naomi Jones
• Tianna Jones
• Spandana Jonnalagadda
• Lori Ann Joris
• Joseph E Silver DPM PC
• Shaija Joseph, RPH
• Jun and K Inc
• Cortney Kacala

• Clinical Psychologist in Westland, MI
• Providers in Westland, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.