JORDAN KNEPPER (NPI# 1760610885) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760610885 |
| Entity Type | Individual |
| Full Name | JORDAN KNEPPER |
| Credential | M.D. |
| Practice Address |
5325 Elliott Dr Ste 104 Ypsilanti MI 48197-8633 |
| Mailing Address |
24 Frank Lloyd Wright Dr J2000 Ann Arbor MI 48105-9484 |
| Practice Telephone | 7347128150 |
| Practice Fax Number | 7347128151 |
| Mailing Telephone | 7347476766 |
| Mailing Fax Number | 7342223100 |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2015-06-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
4301094187 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
5325 ELLIOTT DR STE 104 |
| City | YPSILANTI |
| State | MI |
| Zip Code | 48197-8633 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245237387 | Susan R. Illikman | Nurse Practitioner | 5325 Elliott Dr, Ypsilanti, MI 48197-8633 | 2005-07-05 |
| 1710533799 | Catherine I Giles | Nurse Practitioner | 5325 Elliott Dr, Ypsilanti, MI 48197-8633 | 2019-08-14 |
| 1083102214 | Christine Glowacki | Nurse Practitioner | 5325 Elliott Dr, Ypsilanti, MI 48197-8633 | 2018-04-24 |
| 1619488384 | Elizabeth H Stalder | Nurse Practitioner | 5325 Elliott Dr, Ypsilanti, MI 48197 | 2017-10-20 |
| 1609312420 | Terri Lynn Trombley | Registered Nurse | 5325 Elliott Dr, Ypsilanti, MI 48197-8633 | 2017-01-18 |
| 1235685041 | Diana Rego | Nurse Practitioner | 5325 Elliott Dr, Suite 104, Ypsilanti, MI 48197-8633 | 2016-08-31 |
| 1184170524 | Cristina Hauncher | Dietitian, Registered | 5325 Elliott Dr, Ypsilanti, MI 48197-8633 | 2016-08-26 |
| 1629524194 | Zachary Ryan York | Nurse Practitioner | 5325 Elliott Dr, Ypsilanti, MI 48197-8633 | 2016-08-25 |
| 1225583362 | Kathleen Ritzert | Nurse Practitioner | 5325 Elliott Dr, Ypsilanti, MI 48197-8633 | 2016-08-18 |
| 1902359094 | St Joseph Mercy Hospital | Clinic/Center | 5325 Elliott Dr, Sutie 105, Ypsilanti, MI 48197-8633 | 2016-07-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700423092 | Devika Dibya Choudhuri | Counselor | 135 Porter West Circle Drive, Ypsilanti, MI 48197 | 2019-12-05 |
| 1770128837 | Brian Lee Shue | Registered Nurse | 6277 Maplehurst Dr, Ypsilanti, MI 48197 | 2019-11-13 |
| 1639721566 | Darlene E Bellers | 845 W. Circle Dr, Suite 160, Ypsilanti, MI 48197 | 2019-07-11 | |
| 1073165874 | Eastern Michigan University | Dietitian, Registered | Suite 160 Rackham, Ypsilanti, MI 48197 | 2019-07-11 |
| 1447815469 | Rainbow Rehabilitation Centers, Inc. | Community Based Residential Treatment Facility, Mental Illness | 6200 Textile Rd, Ypsilanti, MI 48197 | 2019-05-06 |
| 1417416298 | Justin Brewer | Student in an Organized Health Care Education/Training Program | 5333 Mcauley Drive Suite 2115, Ypsilanti, MI 48197 | 2019-03-19 |
| 1124519780 | Great Lakes Mindfulness LLC | Community/Behavioral Health | 4007 Carpenter Rd # 280, Ypsilanti, MI 48197 | 2018-05-19 |
| 1841799715 | Bedside Angel's Home Care, LLC | Home Health | 2032 S. Congress Street, Ypsilanti, MI 48197 | 2018-02-06 |
| 1891211777 | Brandon James Kukal | Specialist/Technologist | 799 N Hewitt, Ypslinati, MI 48197 | 2017-08-22 |
| 1669908737 | Michael Bekkerman | Student in an Organized Health Care Education/Training Program | 5303 Elliot Drive, Cancer Center, Ypsilanti, MI 48197 | 2017-05-10 |
| Find all providers in zip 48197 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437660057 | Iha Health Services Corporation | Surgery | 5333 Mcauley Dr Rm 4016, Ypsilanti, MI 48197-1001 | 2017-10-23 |
| 1730333071 | Hue C Thai | Surgery | 5325 Elliott Dr Ste 101, Ypsilanti, MI 48197 | 2008-11-13 |
| 1407210826 | Iha Health Services Corporation | Surgery | 5325 Elliott Dr, Suite 101, Ypsilanti, MI 48197-8633 | 2016-04-12 |
| 1497152243 | St Joseph Mercy Hospital | Surgery | 5333 Mcauley Drive, Suite 1100, Ypsilanti, MI 48197 | 2014-11-21 |
| 1598006074 | Iha Health Services Corporation | Surgery | 5325 Elliott Dr, Suite104, Ypsilanti, MI 48197-8633 | 2013-03-08 |
| 1437195179 | Walter M Whitehouse Jr. | Surgery | 5325 Elliott Dr, Suite 104, Ypsilanti, MI 48197-8633 | 2006-06-21 |
| 1578507554 | Michael J Heidenreich | Surgery | 5325 Elliott Dr, Suite 104, Ypsilanti, MI 48197-8633 | 2006-06-16 |
| 1205870292 | Brian G Halloran | Surgery | 5325 Elliott Dr, Suite 104, Ypsilanti, MI 48197-8633 | 2006-06-16 |
| 1063459659 | Restoration Vein Care, Plc | Surgery | 5333 Mcauley Dr, Suite 4016, Ypsilanti, MI 48197-1014 | 2006-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760900138 | Integrated Vascular Vein Center of Michigan PC | Surgery | 600 Health Park Blvd Ste G, Grand Blanc, MI 48439-2558 | 2017-09-06 |
| 1770036147 | Joseph P. Elliott Jr. | Surgery | 3282 Woodview Lake Rd, West Bloomfield, MI 48323-3570 | 2016-08-02 |
| 1043676661 | Integrative Cardiovascular Health & Wellness | Surgery | 3250 Woods Way, Suite 9, Petoskey, MI 49770-7628 | 2016-01-12 |
| 1124411244 | Vascular Surgery Assoc, PC | Surgery | 1122 S Lapeer Rd Ste C, Lapeer, MI 48446-3387 | 2015-03-13 |
| 1013309988 | Bloomfield Vein & Vascular Pllc | Surgery | 43700 Woodward Ave Ste 207, Bloomfield Hills, MI 48302-5061 | 2015-03-02 |
| 1114288206 | Scott Bendix | Surgery | 28100 Grand River Ave Ste 200, Farmington Hills, MI 48336-5969 | 2012-06-05 |
| 1942561428 | Charles J Shanley Md PC | Surgery | 1001 Audubon Rd, Grosse Pointe, MI 48230-1406 | 2012-05-31 |
| 1508122995 | Robert J Cardwell Md Pllc | Surgery | 13312 Terry Dr, Shelby Township, MI 48315-5365 | 2012-04-10 |
| 1780919936 | Martin A V Tuma Md Vascular Surgery Pllc | Surgery | 22255 Greemfield Road #250, Southfield, MI 48075 | 2009-10-06 |
| 1437383197 | Barbara D'agnoluzzo Moreira | Surgery | 3663 Woodward Ave Ste 200, Wsu Detroit Medical Center, Detroit, MI 48201-2400 | 2009-05-11 |
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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.