Individual provider Active NPI

Jordana Leanne Latozas, RN, MSN, CCRN, ACNP

  • Acute Care Nurse Practitioner
  • Grand Blanc, MI
National Provider Identifier
1831492123
Registry record updated May 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4704253776 Issued in MI
Practice address
1330 Grand Blanc
Grand Blanc, MI 48439-5801
Phone
(734) 464-0887
Fax
(734) 402-0254
NPI assigned
Dec 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704253776 MI
Adult Health Nurse Practitioner 363LA2200X 4704253776 MI
Acute Care Nurse Practitioner 363LA2100X 4704253776 MI Primary

Addresses

Primary practice location

1330 Grand Blanc
Grand Blanc, MI 48439-5801

Mailing address

36115 Schoolcraft Rd
Livonia, MI 48150-1216
Phone (734) 464-0887

Other names 1

  • Miss Jordana Leanne Laforest Former name

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111128000544 MI Practitioner - Nurse Practitioner 6305010588 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Recovery Mobile ClinicGroup PAC ID 9032532528, 9 clinicians

Practice addresses (Care Compare)

3050 Steeple Hill Rd
White Lake, MI 48383-1864
Phone (248) 563-5735

Hospital & facility affiliations

  • Insight Hospital and Medical Center Coldwater Hospital, Coldwater, MI, CCN 230022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704253776MIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Raghad Lepley MD PC CurrentSince Apr 25, 2016 Accepting new patients
Recovery Mobile Clinic Acute Care CurrentSince Feb 5, 2020 Accepting new patients

Locations

7111 Dixie Hwy
Clarkston, MI 48346
Phone (248) 567-2334

147 N Milford Rd
Ste 101
Highland, MI 48357
Phone (248) 887-3900

4706 Product Dr
Ste 3
Wixom, MI 48393

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.

Hospital & facility affiliations 1

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": "1291766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590537600000",
    "number": "1831492123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36115 SCHOOLCRAFT RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501216",
            "telephone_number": "734-464-0887",
            "fax_number": "734-402-0254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 GRAND BLANC",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484395801",
            "telephone_number": "734-464-0887",
            "fax_number": "734-402-0254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATOZAS",
        "first_name": "JORDANA",
        "middle_name": "LEANNE",
        "name_prefix": "Mrs.",
        "credential": "RN, MSN, CCRN, ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-08",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704253776",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704253776",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704253776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDANA",
            "last_name": "LAFOREST",
            "middle_name": "LEANNE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Blanc, MI

Sources for this page

Verify at the official NPI Registry.