Individual provider Active NPI

Rita Ramzi Fakhoury, CRNA

  • Certified Registered Nurse Anesthetist
  • Ann Arbor, MI
National Provider Identifier
1174647549
Registry record updated Nov 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704230371 Issued in MI
Practice address
1500 East Medical Center Dr
1H247 University Hospital
Ann Arbor, MI 48109-4280
Phone
(734) 936-4280
NPI assigned
Mar 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4704230371 MI Primary

Addresses

Primary practice location

1500 East Medical Center Dr
1H247 University Hospital
Ann Arbor, MI 48109-4280

Mailing address

3621 S State St
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047

Other names 1

  • Rita Jiddou Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070612000611 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 9032217237 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Michigan Aas LLCGroup PAC ID 9931324076, 38 clinicians
Northwestern Services LLCGroup PAC ID 4486723657, 47 clinicians
ASC Services of Michigan LLCGroup PAC ID 3971733569, 14 clinicians

Practice addresses (Care Compare)

1500 E Medical Ctr Dr
Ann Arbor, MI 48109-5000
Phone (734) 936-4000

25500 Meadowbrook Rd
Suite 110
Novi, MI 48375-1879
Phone (248) 477-2200

30055 Northwestern Hwy
Suite L 60
Farmington Hills, MI 48334-3274
Phone (248) 265-6555

33400 6 Mile Rd
Suite B
Livonia, MI 48152-3165
Phone (734) 452-7111

4270 Plymouth Rd
Ann Arbor, MI 48109-2700
Phone (734) 936-4000

7500 Challis Rd
Brighton, MI 48116-9416
Phone (734) 936-4000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Services, LLC CurrentSince Apr 4, 2025 Accepting new patients
West Michigan Aas LLC CurrentSince May 1, 2025 Accepting new patients
Novi Aas LLC CurrentSince Mar 1, 2026 Accepting new patients
Pediatric Anesthesia Associates, PC CurrentSince Dec 8, 2025 Accepting new patients
ASC Services of Michigan LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2021 Accepting new patients
Regents of the University of Michigan CurrentSince Feb 13, 2007 Accepting new patients
Northwestern Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 4, 2025 Accepting new patients
Regents of the University of Michigan Nurse Anesthetist, Certified Registered CurrentSince Feb 13, 2007 Accepting new patients
Crnas of Michigan Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

1500 E Medical Center Dr
#1H247
Ann Arbor, MI 48109
Phone (734) 936-4280

3621 S State St
#700
Ann Arbor, MI 48108

4270 Plymouth Rd
Ann Arbor, MI 48109
Phone (734) 232-3000

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

30055 Northwestern Hwy
Ste L-60
Farmington Hills, MI 48334
Phone (248) 265-6555

4024 Park East Ct SE
Grand Rapids, MI 49546
Phone (231) 592-3102

3800 Centennial Dr
Grass Lake, MI 49240
Phone (517) 701-3100

33400 6 Mile Rd
Ste B
Livonia, MI 48152
Phone (734) 452-7111

25500 Meadowbrook Rd
Ste 110
Novi, MI 48375
Phone (248) 477-0220

43422 W Oaks Dr
Novi, MI 48377
Phone (248) 229-4658

1560 E Maple Rd
#100
Troy, MI 48083
Phone (248) 817-2001

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290124800000",
    "number": "1174647549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "address_2": "700 KMS PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-936-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 EAST MEDICAL CENTER DR",
            "address_2": "1H247 UNIVERSITY HOSPITAL",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481094280",
            "telephone_number": "734-936-4280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAKHOURY",
        "first_name": "RITA",
        "middle_name": "RAMZI",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2010-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704230371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RITA",
            "last_name": "JIDDOU",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.