Active NPI
Jimmy Kassis
- Ambulatory Care Registered Nurse
- Canton, MI
National Provider Identifier
1265306211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Care Registered Nurse
- License
- 4704377909
- Practice address
- 5900 N Lotz Rd
Canton, MI 48187-4331 - Phone
- (734) 394-4500
- NPI assigned
- Oct 2, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Care Registered Nurse | 163WP2201X | 4704377909 | MI | Primary |
Addresses
Primary practice location
5900 N Lotz Rd
Canton, MI 48187-4331
Mailing address
5900 N Lotz Rd
Canton, MI 48187-4331
Phone (734) 394-4500
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 |
|---|---|---|---|
| 4704377909 | MI | MD | Ambulatory Care Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1759363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774224000000",
"number": "1265306211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5900 N LOTZ RD",
"city": "CANTON",
"state": "MI",
"postal_code": "481874331",
"telephone_number": "734-394-4500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5900 N LOTZ RD",
"city": "CANTON",
"state": "MI",
"postal_code": "481874331",
"telephone_number": "734-394-4500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KASSIS",
"first_name": "JIMMY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-10-02",
"last_updated": "2026-03-23",
"certification_date": "2026-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "163WP2201X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Registered Nurse, Ambulatory Care",
"state": "MI",
"license": "4704377909",
"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 Mar 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.