KENNETH A JORDAN (NPI# 1235186438) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235186438 |
| Entity Type | Individual |
| Full Name | KENNETH A JORDAN |
| Credential | MD |
| Practice Address |
295 Maple St Ste 202 Tawas City MI 48763-9352 |
| Mailing Address |
117 W Paterson St Attn: Paula Jackson Kalamazoo MI 49007 |
| Practice Telephone | 9893626108 |
| Practice Fax Number | 9893620161 |
| Mailing Telephone | 2693492641 |
| Mailing Fax Number | 2692012855 |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2019-07-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 4301040286 | MI | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 505 E Alcott St, Kalamazoo, MI 49001 | 2693492641 | 2692012855 |
| 1362 Hickory Hollow Dr, Flint, MI 485322035 | 8105169781 | |
| 117 W Paterson St, Kalamazoo, MI 490072557 | 2693492641 | 2692012855 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801935044 | Kenneth Michael Jordan | Radiologic Technologist | 4201 E Loop 820 S, Ste C, Ft Worth, TX 76119-4443 | 2007-02-05 |
| 1710081708 | Kenneth N Jordan | Family Medicine | 520 West Madison Street, Madison Street Clinic PC, Pontiac, IL 61764 | 2006-09-11 |
| 1902867252 | Kenneth Wesley Jordan | Chiropractor | 705 North Fraser St, Georgetown, SC 29442-0958 | 2006-03-28 |
| 1477537116 | Kenneth George Jordan | Specialist | 1660 Plum Ln, Redlands, CA 92374-4532 | 2005-12-06 |
| 1366049900 | Kenneth Bernard Jordan | Psychiatry & Neurology | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-10-06 |
| 1285278580 | Kenneth Warren Jordan | Speech-Language Pathologist | 2600 Compass Rd, Glenview, IL 60026-8001 | 2019-10-30 |
| 1548739147 | Kenneth Jordan | Counselor | 1700 Airport Way S, Seattle, WA 98134-1618 | 2018-11-13 |
| 1386122141 | Kenneth Jordan | Social Worker | 29 Maple St, Littleton, NH 03561 | 2018-08-03 |
| 1932440385 | Kenneth W Jordan | Pharmacist | 701 E Milam St, Mexia, TX 76667-2445 | 2013-03-11 |
| 1184628505 | Kenneth Wayne Jordan | Pediatrics | 2100 Erwin Rd, Durham, NC 27705-3941 | 2005-06-13 |
| Street Address |
295 MAPLE ST STE 202 |
| City | TAWAS CITY |
| State | MI |
| Zip Code | 48763-9352 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376082487 | Amanda Jacques | Nurse Practitioner | 295 Maple St Ste 202, Tawas City, MI 48763-9352 | 2017-02-22 |
| 1740420322 | Elizabeth Myers | Nurse Practitioner | 295 Maple St Ste 202, Tawas City, MI 48763-9352 | 2009-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720447006 | Josie Short | Student in an Organized Health Care Education/Training Program | 127 Wheeler Street, Tawas, MI 48763 | 2016-02-16 |
| 1689052698 | Victoria Mcgillis | Nurse Practitioner | 325 E M 55 Ste B, Tawas City, MI 48763 | 2015-05-11 |
| 1942500160 | Jeffrey M Chadwick O D P C | Optometrist | 325 M-55, Tawas City, MI 48763 | 2010-10-22 |
| 1659536068 | Josip Petani | Pediatrics | 101 W. Lake St, Tawas City, MI 48763 | 2008-07-24 |
| 1790963312 | Phillip A Wienczewski Pllc | Dentist | 671 E M 55, Tawas City, MI 48763 | 2008-02-06 |
| 1902090038 | Life Family Chiropractic LLC | Chiropractor | 196 M 55, Life Family Chiropractic, Tawas City, MI 48763 | 2007-08-31 |
| 1467586446 | Thomas Aldrich Dawson | Dentist | 508 Hemlock Avenue, Tawas City, MI 48763 | 2007-03-14 |
| 1497819056 | Phillip Allen Wienczewski | Dentist | 671 E M55, Tawas City, MI 48763 | 2006-12-20 |
| 1821163106 | Charles Edward Kudwa | Dentist | 510 West Lake St, Tawas City, MI 48763 | 2006-11-21 |
| 1720017312 | Jeffrey Michael Chadwick | Optometrist | 325 M-55 East, Tawas City, MI 48763 | 2006-07-03 |
| Find all providers in zip 48763 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104869171 | Joseph J Vanderveen | Internal Medicine | 312 W M 55, Tawas City, MI 48763-9253 | 2006-06-14 |
| 1629018494 | Northwoods Internal Medicine, P.C. | Internal Medicine | 312 M 55 W, Tawas City, MI 48763-9253 | 2006-06-08 |
| 1386922771 | Sandesh Murali | Internal Medicine | 295 Maple St, Tawas City, MI 48763-9352 | 2011-08-02 |
| 1457579898 | Steven Dowdy | Internal Medicine | 295 Maple St, Suite 203, Tawas City, MI 48763-9352 | 2007-04-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053910687 | Berry Johnson Health Pllc | Internal Medicine | 30123 Rock Creek Dr, Southfield, MI 48076-5358 | 2020-10-24 |
| 1386243178 | Hoover Internal Medicine Pllc | Internal Medicine | 4067 Georgia St, Hamtramck, MI 48212 | 2020-10-22 |
| 1790399798 | Enhua Wang | Internal Medicine | 1215 E Michigan Ave Ste 500, Lansing, MI 48912-1811 | 2020-09-07 |
| 1093329849 | Hey Doc, P.C. | Internal Medicine | 1431 Washington Blvd Apt 2510, Detroit, MI 48226-1729 | 2020-08-31 |
| 1568074375 | Mohammad Nadeemullah Pllc | Internal Medicine | 5400 Waldenhill Ct, Superior Twp, MI 48198-9654 | 2020-08-21 |
| 1356953723 | Eager Internal Medicine, Pllc | Internal Medicine | 720 N Lapeer Rd Ste 101, Lake Orion, MI 48362-4011 | 2020-08-18 |
| 1144838335 | Ranim Chamseddin | Internal Medicine | 3200 Five Points Dr Unit 110, Auburn Hills, MI 48326-2372 | 2020-07-14 |
| 1407474562 | Pravalika Rudraraju | Internal Medicine | 6245 Inkster Rd Dept Of, Garden City, MI 48135-4001 | 2020-07-06 |
| 1780200469 | Abed L Dabaja | Internal Medicine | 6245 Inkster Rd # Gme, Garden City, MI 48135-4001 | 2020-06-18 |
| 1265057624 | Olga Romina Gomez Rojas | Internal Medicine | 3607 W 13 Mile Rd, Royal Oak, MI 48073 | 2020-06-11 |
| Find all providers with the same taxonomy | ||||
| City | TAWAS CITY |
| Zip Code | 48763 |
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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.