Individual provider Active NPI

Christine Ghattas

  • Family Nurse Practitioner
  • Royal Oak, MI
National Provider Identifier
1063004695
Registry record updated Sep 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704336745 Issued in MI
Practice address
3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone
(832) 875-7306
NPI assigned
Feb 4, 2021
Last updated
Sep 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704336745 MI Primary
Registered Nurse 163W00000X 4704336745 MI

Addresses

Primary practice location

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712

Mailing address

1134 Woodslee Dr
Troy, MI 48083-6602
Phone (832) 875-7306

Other practice location 1

1134 Woodslee Dr
Troy, MI 48083-6602
Phone (832) 875-7306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220120000634 MI Practitioner - Nurse Practitioner 2860884038 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704336745MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sami Abu Farha MD PC CurrentSince Jan 2, 2024 Accepting new patients
Oakland Colon & Rectal Assoc P C CurrentSince Jan 12, 2022 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Aug 11, 2024 Accepting new patients
Alpha Urgent Care PLLC Past Accepting new patients

Locations

5280 Oakman Blvd
Dearborn, MI 48126
Phone (313) 846-1997

1121 Crooks Rd
Royal Oak, MI 48067
Phone (248) 541-7023

13 N Washington St
Ypsilanti, MI 48197
Phone (734) 329-4620

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: christine.ghattas.1@31078.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1612396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1063004695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1134 WOODSLEE DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480836602",
            "telephone_number": "832-875-7306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736712",
            "telephone_number": "832-875-7306"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1134 Woodslee Dr",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480836602",
            "country_code": "US",
            "telephone_number": "832-875-7306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHATTAS",
        "first_name": "CHRISTINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-04",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704336745",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704336745",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.