Jordan Liles

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

66685 Issued in AZ

Practice address

8630 E Via de Ventura Ste 201
Scottsdale, AZ 85258-3358

Phone

(480) 558-3744

Fax

(480) 558-3801

NPI assigned

Apr 3, 2016

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Sports Medicine

Education

Loyola University of Chicago, Stritch School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

VHS Outpatient Clinics IncGroup PAC ID 4486566726, 206 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jordan.liles.1@600.direct.athenahealth.com

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.

• VHS Outpatient Clinics, Inc.

  dba Abrazo Medical Group

  • Multi-Specialty Clinic/Center
  • Goodyear, AZ
  • NPI 1912979964
  Medicare reassignment Care Compare group NPD
• VHS Outpatient Clinics, Inc.

  dba Arizona Sports Medicine Center (ASMC)

  • Durable Medical Equipment & Medical Supplies
  • Scottsdale, AZ
  • NPI 1891302790
  NPD

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

{
    "created_epoch": "1459641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1952764219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8630 E VIA DE VENTURA STE 201",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852583358",
            "telephone_number": "480-558-3744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8630 E VIA DE VENTURA STE 201",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852583358",
            "telephone_number": "480-558-3744",
            "fax_number": "480-558-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILES",
        "first_name": "JORDAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-03",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "AZ",
            "license": "66685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lighthouse Center Inc. (Sabra House DBA The Lighthouse Center)
• Lighthouse Counseling and Psychotherapy PLLC
• Lighthouse Psychology LLC
• Tenesa Stokes Lightsey, FNP-C
• Robert David Ligorsky, D.O.
• Sean T Lille, MD
• Joseph L Lillo, DO, FNLA, FAPCR
• Mandy Lim, D.O.
• Pei-Wen Lim, M.D.
• Victoria Limbeck, STUDENT

• Sports Medicine (Orthopaedic Surgery) Physician in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.

Verify at the official NPI Registry.