DR. MICHAEL R JORDAN (NPI# 1053323469) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053323469 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL R JORDAN |
| Credential | M.D. |
| Practice Address |
1200 Driving Park Ave Newark NY 14513-1057 |
| Practice Telephone | 3153592660 |
| Practice Fax Number | 3153592635 |
| Mailing Telephone | 3153592660 |
| Mailing Fax Number | 3153592635 |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 145672 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00596429 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861889776 | Michael Andrew Jordan | Ophthalmology | 825 Nicollet Mall Ste 2000, Minneapolis, MN 55402-2708 | 2015-04-17 |
| 1629493275 | Michael Jordan | Preventive Medicine | 2 Stone Gate Ct, Setauket, NY 11733-1346 | 2014-02-19 |
| 1134469448 | Michael Jack Jordan | Counselor | 1418 Lindale Ave, Norman, OK 73069-4423 | 2013-02-22 |
| 1598971723 | Michael Wayne Jordan | Psychiatry & Neurology | 3116 S Mill Ave, #605, Tempe, AZ 85282-3657 | 2007-05-15 |
| 1932283025 | Michael Thomas Jordan | Physician Assistant | Seminole Blvd, St. Petersburg, FL 33744 | 2006-10-25 |
| 1588755862 | Michael Arthur Jordan | Optometrist | 3063 Dauphin St, Mobile, AL 36606-4040 | 2006-09-28 |
| 1205816840 | Michael Couzens Jordan | Pediatrics | 4150 Woodlands Pkwy, Suite B, Palm Harbor, FL 34685-3495 | 2006-01-19 |
| 1104470848 | Michael Jordan | Pharmacist | 1485 Harrison Blvd, Ogden, UT 84404-6093 | 2019-07-31 |
| 1376103986 | Michael K Jordan | Behavior Technician | 16200 19 Mile Rd, Clinton Twp, MI 48038-1103 | 2019-06-17 |
| 1699244418 | Michael D Jordan | Case Manager/Care Coordinator | 124 Carmen Ln Ste A, Santa Maria, CA 93458-7768 | 2018-11-21 |
| Street Address |
1200 DRIVING PARK AVE |
| City | NEWARK |
| State | NY |
| Zip Code | 14513-1057 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396741898 | Lawrence N. Chessin | Internal Medicine | 1200 Driving Park Ave, Newark, NY 14513-1057 | 2005-06-21 |
| 1477162725 | Aidan Sullivan | Physician Assistant | 1200 Driving Park Ave, Newark, NY 14513-1090 | 2020-07-23 |
| 1649898834 | Nicholas D Biermann | Physician Assistant | 1200 Driving Park Ave, Newark, NY 14513-1090 | 2020-07-14 |
| 1780222604 | Erin Hart | Physical Therapist | 1200 Driving Park Ave, Newark, NY 14513-1090 | 2019-12-11 |
| 1861030785 | Lauren Conaty | Physical Therapist | 1200 Driving Park Ave, Newark, NY 14513-1090 | 2019-12-11 |
| 1255978540 | Andrea Lorene Ide | Physical Therapist | 1200 Driving Park Ave, Newark, NY 14513-1090 | 2019-12-05 |
| 1326682618 | Thomas William Jackson Mspt | Physical Therapist | 1200 Driving Park Ave, Newark, NY 14513-1090 | 2019-10-30 |
| 1578113189 | Natalie A Davidson | Nurse Practitioner | 1200 Driving Park Ave, Newark, NY 14513 | 2019-09-16 |
| 1164076659 | Meritt F Rogers | Physician Assistant | 1200 Driving Park Ave, Newark, NY 14513-1090 | 2019-08-01 |
| 1992366744 | Allison Marie Triou | Physician Assistant | 1200 Driving Park Ave, Newark, NY 14513-1090 | 2019-06-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881215648 | Susan Marie Oberdorf | Speech-Language Pathologist | 133 Elmwood, Newark, NY 14513 | 2020-05-04 |
| 1871077404 | Aisha E Wagner | Nurse Practitioner | 1304 Driving Park Avenue, Newark, NY 14513 | 2018-09-19 |
| 1689192817 | Melanie Swarthout | Case Manager/Care Coordinator | 150 Van Buren St., Newark, NY 14513 | 2017-09-08 |
| 1942650882 | Donna Joy Collins I | Speech-Language Pathologist | 848 Pierson Avenue, Newark, NY 14513 | 2016-06-21 |
| 1972952661 | Cj-mak Transportation, Inc. | Non-emergency Medical Transport (VAN) | 227 State Farm Road, Newark, NY 14513 | 2016-06-03 |
| 1306214473 | Stephanie Belli | Licensed Practical Nurse | 5904 Austin Road, Newark, NY 14513 | 2015-09-08 |
| 1992186712 | Nicole Harris | Nursing Facility/Intermediate Care Facility | 132 Willow Avenue, Newark, NY 14513 | 2015-06-17 |
| 1861802373 | Jeffrey Spencer | Urology | 1202 Driving Park Ave Ste 5, Newark, NY 14513 | 2014-05-06 |
| 1609126648 | Natasha Triplett | Student in an Organized Health Care Education/Training Program | 439 W. Maple Ave, Perkins Elementary, Newark, NY 14513 | 2012-09-18 |
| 1922377902 | Lisa E. Williams | Licensed Practical Nurse | 701 Peirson Ave., Newark, NY 14513 | 2011-12-21 |
| Find all providers in zip 14513 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578084448 | Valerie Louissaint | Pediatrics | 240 Osborne Ter, Newark, NJ 07112-2130 | 2017-06-30 |
| 1396129912 | Madheea Siddiqi | Pediatrics | 185 S Orange Ave # 972-6015, Newark, NJ 07103-2757 | 2015-07-14 |
| 1124433024 | Priyanka Vakati | Pediatrics | 4755 Ogletown Stanton Rd Dept Of, Newark, DE 19718-2200 | 2014-06-30 |
| 1588920854 | Stephanie J Lempel | Pediatrics | 185 South Orange Avenue - F603, Newark, NJ 07103 | 2012-04-11 |
| 1427360577 | Rula Nassar | Pediatrics | 4755 Ogletown - Stanton Rd, Map Suite 217, Newark, DE 19713 | 2010-07-06 |
| 1235450883 | Jimisha Patel | Pediatrics | 1864 Tamarack Road, Newark, OH 43055 | 2010-06-17 |
| 1235463548 | First State Pediatrics, LLC | Pediatrics | 210 Christiana Medical Ctr, Newark, DE 19702-1652 | 2009-09-21 |
| 1528224615 | Juan Gadea | Pediatrics | 179 W Chestnut Hill Rd Ste 6, Newark, DE 19713-2210 | 2008-07-29 |
| 1821269630 | Chandra Gupta | Pediatrics | 156 Roseville Avenue, Newark, NJ 07107 | 2008-03-19 |
| 1669676219 | Justin M. D'antuono | Pediatrics | 1400 Peoples Plaza, Suite 300, Newark, DE 19702-5708 | 2007-06-14 |
| Find all providers in NEWARK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.