JORDIN SHELLEY RODEN-FOREMAN DO
NPI 1174374516
Student in an Organized Health Care Education/Training Program in Warren, MI

Q: What is Jordin Roden-foreman's NPI number?

The NPI number for Jordin Roden-foreman is 1174374516. It was assigned to this individual provider in the NPPES registry on April 1, 2024.

Q: What is Jordin Roden-foreman's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since April 01, 2024PECOS Enrolled

12000 E 12 MILE RD, WARREN, MI 48093(248) 546-2600 Get Directions Write a Review

NPPES record last updated: September 1, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 1, 2025, Apr 1, 2024 (2 updates tracked since 2024).

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About Jordin Shelley Roden-foreman Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JORDIN SHELLEY RODEN-FOREMAN DO (NPI 1174374516) is an individual student in an organized health care education/training program in Warren, Michigan and active in the NPI registry since April 2024. She is enrolled in Medicare PECOS and maintains a secondary practice location in Dallas.

NPPES Registry Identity

NPI1174374516

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameJORDIN SHELLEY RODEN-FOREMANCredential: DO

Location Address12000 E 12 MILE RDWarren, MI 48093-3570

Mailing Address11800 E 12 Mile RdWarren, MI 48093-3472 · (469) 236-4050

Phone(248) 546-2600

Sole ProprietorNo

Enumeration DateApril 1, 2024

Last NPPES UpdateSeptember 1, 20252 updates tracked since enumeration

NPPES CertifiedSeptember 1, 2025

✔ NPI 1174374516 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

12000 E 12 MILE RD, Warren, MI 48093

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Secondary Practice Location 1

Location 13500 Gaston AveDallas, TX 75246-2088 · Phone (214) 820-2362

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jordin Shelley Roden-foreman Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MANSUR ROY DDS

Dentist (Periodontics)