Courtney Elyse Fezzey

Primary specialty

Critical Care Pediatric Nurse PractitionerTaxonomy code 363LP0222X

License

4704268781 Issued in MI

Practice address

3200 E Lafayette St
Detroit, MI 48207-3812

Phone

(313) 567-0534

Fax

(313) 567-0560

NPI assigned

Jan 7, 2014

Sex

Female

Sole proprietor

No

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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

• Henry Ford Health System-School Based Health Initiative

  • Professional Counselor
  • Detroit, MI
  • NPI 1104010578
  NPD (past)
• Macomb Pediatric Associatea P.C

  • Pediatrics Physician
  • Warren, MI
  • NPI 1245453125
  NPD (past)

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

{
    "created_epoch": "1389052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549584000000",
    "number": "1073935383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 E LAFAYETTE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482073812",
            "telephone_number": "313-567-0534",
            "fax_number": "313-567-0560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 E LAFAYETTE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482073812",
            "telephone_number": "313-567-0534",
            "fax_number": "313-567-0560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "39200 Garfield Rd",
            "address_2": "Suite E",
            "address_purpose": "LOCATION",
            "city": "Clinton Twp",
            "state": "MI",
            "postal_code": "480384095",
            "country_code": "US",
            "telephone_number": "586-263-4010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FEZZEY",
        "first_name": "COURTNEY",
        "middle_name": "ELYSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-07",
        "last_updated": "2019-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "MI",
            "license": "4704268781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolyn Anne Ferrer, MOT, OTRL
• Rina Ferrera-Reid, NP
• Jackson Swift Ferris
• Dominic Michael Ferro
• Chaya Feuerstein
• Noah Vincent Fiala, DO
• Oswaldo Gabriel Fiallos Encalada, LMSW
• Fibers of the Family LLC
• Taylor Jordan Ficht, CD
• Autumn Fick

• Critical Care Pediatric Nurse Practitioner in Detroit, MI
• Providers in Detroit, MI by specialty
• Critical Care Pediatric Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.