NPIMap

Organization Active NPI

Nephron Clinic PC

  • Nephrology Physician
  • Dearborn, MI
National Provider Identifier
1104118116
Registry record updated May 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
NEPHRON CLINIC PC
Practice address
2040 Monroe St
Ste 209
Dearborn, MI 48124-2950
Phone
(313) 359-2100
Fax
(313) 359-2104
NPI assigned
May 9, 2011
Last updated
May 9, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2011

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

Authorized official

Name
Rabih M Bazzi, MDNPI 1235130691
Title
President
Phone
(313) 359-2100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X NU Primary

Addresses

Primary practice location

2040 Monroe St
Ste 209
Dearborn, MI 48124-2950

Mailing address

6463 Miller Rd
Dearborn, MI 48126-2363
Phone (313) 359-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110811000164 MI Part B Supplier - Clinic/Group Practice 4587833413 Receives reassigned benefits from 7 practitioners
Practice locations: Dearborn, MI

National Provider Directory

National Provider Directory

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

Locations

1537 Monroe St
Dearborn, MI 48124
Phone (313) 359-2100

1537 Monroe St
Ste 100
Dearborn, MI 48124
Phone (313) 359-2100

13415 Schaefer Hwy
Detroit, MI 48227

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1304899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304899200000",
    "number": "1104118116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6463 MILLER RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262363",
            "telephone_number": "313-359-2100",
            "fax_number": "313-359-2104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 MONROE ST",
            "address_2": "STE 209",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242950",
            "telephone_number": "313-359-2100",
            "fax_number": "313-359-2104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEPHRON CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-09",
        "last_updated": "2011-05-09",
        "status": "A",
        "authorized_official_last_name": "BAZZI",
        "authorized_official_first_name": "RABIH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-359-2100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.