Individual provider Active NPI

Michael Jordan Caldwell, NP-C

  • Nurse Practitioner
  • Southfield, MI
National Provider Identifier
1871108803
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704288413 Issued in MI
Practice address
16001 W 9 Mile Rd
Southfield, MI 48075-4818
Phone
(248) 849-5806
Fax
(248) 849-5489
NPI assigned
Sep 15, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704288413 MI Primary

Addresses

Primary practice location

16001 W 9 Mile Rd
Southfield, MI 48075-4818

Mailing address

PO Box 14128
Belfast, ME 04915-4032
Phone (248) 680-8000

Other practice location 1

1768 Ford Ave
Wyandotte, MI 48192-2306
Phone (734) 299-0712

Other practice location 2

20789 Gibraltar Rd
Brownstown Twp, MI 48183-5087
Phone (734) 444-2961

Other practice location 3

47601 Grand River Ave
Novi, MI 48374-1233
Phone (248) 465-4311

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
I20220203000095 MI Practitioner - Nurse Practitioner 8325431927 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704288413MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health Providence Hospital CurrentSince Jul 28, 2025 Accepting new patients
Henry Ford Health Providence Hospital Nurse Practitioner CurrentSince Jul 28, 2025 Accepting new patients
Blue Water Urgent Care PLLC Nurse Practitioner PastSince Jul 1, 2026 Accepting new patients
Southshore Urgent Care PLLC. PastSince Jun 1, 2019 Accepting new patients

Locations

47601 Grand River Ave
Novi, MI 48374
Phone (248) 465-4100

16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000

Interoperability endpoints

  • Direct secure messaging: mcaldwell221218@direct.hfhs.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1600128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1871108803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14128",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154032",
            "telephone_number": "248-680-8000",
            "fax_number": "248-680-8030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16001 W 9 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754818",
            "telephone_number": "248-849-5806",
            "fax_number": "248-849-5489"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1768 Ford Ave",
            "address_purpose": "LOCATION",
            "city": "Wyandotte",
            "state": "MI",
            "postal_code": "481922306",
            "country_code": "US",
            "telephone_number": "734-299-0712",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20789 Gibraltar Rd",
            "address_purpose": "LOCATION",
            "city": "Brownstown Twp",
            "state": "MI",
            "postal_code": "481835087",
            "country_code": "US",
            "telephone_number": "734-444-2961",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "47601 Grand River Ave",
            "address_purpose": "LOCATION",
            "city": "Novi",
            "state": "MI",
            "postal_code": "483741233",
            "country_code": "US",
            "telephone_number": "248-465-4311",
            "fax_number": "248-465-4651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALDWELL",
        "first_name": "MICHAEL",
        "middle_name": "JORDAN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-15",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704288413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.