Athar Ghannam, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301509386 Issued in MI

Practice address

3235 E Michigan Ave Ste 100
Jackson, MI 49202-3971

Phone

(517) 205-3280

Fax

(517) 205-1181

NPI assigned

Jun 23, 2020

Last updated

Nov 7, 2023By the provider in NPPES

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

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156
• Trinity Health Oakland Hospital Hospital, Pontiac, MI, CCN 230029
• St Joe Mercy Hospital System Livonia Hospital, Livonia, MI, CCN 230002
• Henry Ford Allegiance Health Hospital, Jackson, MI, CCN 230092

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aghannam3768666@direct.trinity-health.org
• Direct secure messaging: aghannam886974@direct.hfhs.org

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

• Iha Health Services Corporation

  dba IHA Canton Obstetrics and Gynecology

  • Obstetrics & Gynecology Physician
  • Canton, MI
  • NPI 1457408965
  Medicare reassignment Care Compare group NPD
• W. a. Foote Memorial Hospital

  dba Allegiance Health

  • Internal Medicine Physician
  • Jackson, MI
  • NPI 1760437826
  Medicare reassignment NPD
• Iha Health Service Corporation

  dba Trinity Health IHA Medical Group OB/GYN Float

  • Obstetrics & Gynecology Physician
  • Ypsilanti, MI
  • NPI 1831053701
  NPD
• Iha Health Services Corporation

  dba IHA Urgent Care-Domino's Farms

  • Urgent Care Clinic/Center
  • Ann Arbor, MI
  • NPI 1992937023
  NPD
• W.a. Foote Memorial Hospital

  dba Henry Ford Allegiance Health

  • Physician Assistant
  • Jackson, MI
  • NPI 1538606348
  NPD
• W.a. Foote Memorial Hospital

  dba Henry Ford Allegiance Health

  • Family Medicine Physician
  • Jackson, MI
  • NPI 1962953034
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Joseph Mercy Hospital

  dba Trinity Heath Ann Arbor Hospital

  • General Acute Care Hospital
  • Ypsilanti, MI
  • NPI 1780658443
  Care Compare affiliation
• St Joseph Mercy Hospital-SMHC

  dba St Joseph Mercy Oakland

  • General Acute Care Hospital
  • Pontiac, MI
  • NPI 1053356352
  Care Compare affiliation
• St Mary Mercy Hospital

  • General Acute Care Hospital
  • Livonia, MI
  • NPI 1790706901
  Care Compare affiliation
• W.a. Foote Memorial Hospital

  dba Henry Ford Allegiance Health

  • General Acute Care Hospital
  • Jackson, MI
  • NPI 1053403402
  Care Compare affiliation

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

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1295351500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3235 E MICHIGAN AVE STE 100",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492023971",
            "telephone_number": "517-205-3280",
            "fax_number": "517-205-1181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3235 E MICHIGAN AVE STE 100",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492023971",
            "telephone_number": "517-205-3280",
            "fax_number": "517-205-1181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "G3230 Beecher Rd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "485323604",
            "country_code": "US",
            "telephone_number": "810-342-5656",
            "fax_number": "810-342-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHANNAM",
        "first_name": "ATHAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-23",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301509386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Mary George
• Roman Rusak Gernat, MD
• Jillian Rnea Gervais, PNP-PC
• Ashley Lynn Geshrick
• Tammy Gessner, LPC
• Stefanie Ghant
• Chelsea Ghastin, RN
• Kamal Taymour Ghazi, LLMSW
• Nelly Saad Eldin Ghazi
• Amre Asad Ghazzal, MD

• Family Medicine Physician in Jackson, MI
• Providers in Jackson, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.