Active NPI
Noor Kassim
- Pharmacist
- Canton, MI
National Provider Identifier
1215618228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302041159
- Practice address
- 2227 Hickory Ridge CT N
Canton, MI 48187-2096 - Phone
- (267) 456-7678
- NPI assigned
- Jul 31, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP0013403 | WV | |
| Pharmacist | 183500000X | 03440536 | OH | |
| Pharmacist | 183500000X | PH240119 | MA | |
| Pharmacist | 183500000X | 5302041159 | MI | Primary |
Addresses
Primary practice location
2227 Hickory Ridge CT N
Canton, MI 48187-2096
Mailing address
2227 Hickory Ridge CT N
Canton, MI 48187-2096
Phone (267) 456-7678
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH240119 | MA | MD | Pharmacist |
| 5302041159 | MI | MD | Pharmacist |
| 03440536 | OH | MD | Pharmacist |
| RP0013403 | WV | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1690761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690761600000",
"number": "1215618228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2227 HICKORY RIDGE CT N",
"city": "CANTON",
"state": "MI",
"postal_code": "481872096",
"telephone_number": "267-456-7678"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2227 HICKORY RIDGE CT N",
"city": "CANTON",
"state": "MI",
"postal_code": "481872096",
"telephone_number": "267-456-7678"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KASSIM",
"first_name": "NOOR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-31",
"last_updated": "2023-07-31",
"certification_date": "2023-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WV",
"license": "RP0013403",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03440536",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH240119",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302041159",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.