Joey Fattizzo, FNP, RN, RDH

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F08170704 Issued in MI

Practice address

45445 Mound Round
Suite 105
Shelby Township, MI 48317

Phone

(586) 200-8707

Fax

(248) 282-1313

NPI assigned

Aug 27, 2017

Sex

Female

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 1, 2025 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1503792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1033636493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1978 CATALPA DR",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480721804",
            "telephone_number": "586-615-2568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45445 MOUND ROUND",
            "address_2": "SUITE 105",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "48317",
            "telephone_number": "586-200-8707",
            "fax_number": "248-282-1313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATTIZZO",
        "first_name": "JOEY",
        "name_prefix": "Miss",
        "credential": "FNP, RN, RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-27",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "F08170704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Shelby Township, MI
• Providers in Shelby Township, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.