Active NPI
Michael Stewart Jordan, LPC-A
- Mental Health Counselor
- Taylorsville, NC
National Provider Identifier
1750898326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- A13423
- Practice address
- 393 3Rd Ave SW
Taylorsville, NC 28681-4180 - Phone
- (828) 848-2515
- NPI assigned
- Jan 4, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | A13423 | NC | Primary |
Addresses
Primary practice location
393 3Rd Ave SW
Taylorsville, NC 28681-4180
Mailing address
2887 Blair Dr
Newton, NC 28658-9773
Phone (828) 320-1151
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4692 Brownsboro Rd
Winston Salem, NC 27106-3410
Phone (337) 991-9276
70 Oak St
Tryon, NC 28782-3797
Phone (828) 859-9161
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A13423 | NC | MD | Mental Health Counselor |
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Durham, NC
- NPI 1770217176
-
- General Practice Physician
- Durham, NC
- NPI 1023083268
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515024000000",
"number": "1750898326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2887 BLAIR DR",
"city": "NEWTON",
"state": "NC",
"postal_code": "286589773",
"telephone_number": "828-320-1151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "393 3RD AVE SW",
"city": "TAYLORSVILLE",
"state": "NC",
"postal_code": "286814180",
"telephone_number": "828-848-2515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "MICHAEL",
"middle_name": "STEWART",
"credential": "LPC-A",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-04",
"last_updated": "2018-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "A13423",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Taylorsville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2018; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.