Kefah Abbas Mazloum

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704341497 Issued in MI

Practice address

205 N East Ave
Jackson, MI 49201-1753

Phone

(517) 205-7836

NPI assigned

Jan 19, 2022

Sex

Male

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, FL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wyandotte Urgent Care ClinicGroup PAC ID 4183996150, 17 clinicians

Emergency Professionals of Michigan PCGroup PAC ID 3274767371, 49 clinicians

Southshore Urgent Care PLLCGroup PAC ID 5698009777, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations (25 of 40)

Interoperability endpoints

• Direct secure messaging: kmazloum358573@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 and National Provider Directory roles.

• Emergency Professionals of Michigan, P.C.

  • Emergency Medicine Physician
  • Dearborn, MI
  • NPI 1952740656
  Medicare reassignment Care Compare group NPD
• Southshore Urgent Care PLLC.

  • Urgent Care Clinic/Center
  • Brownstown TWP, MI
  • NPI 1356804710
  Medicare reassignment Care Compare group NPD
• Wyandotte Urgent Care Clinic

  • Urgent Care Clinic/Center
  • Wyandotte, MI
  • NPI 1316467384
  Medicare reassignment Care Compare group NPD
• Blue Water Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Fort Gratiot, MI
  • NPI 1477135036

  Nurse Practitioner

  Medicare reassignment NPD
• Care Family Medicine Center PLLC

  dba AFC Urgent Care

  • Urgent Care Clinic/Center
  • Commerce Township, MI
  • NPI 1083358782
  Medicare reassignment NPD
• Henry Ford Health St. John Hospital

  dba St John North Shores Hospital

  • Podiatrist
  • Harrison Township, MI
  • NPI 1043478910
  Medicare reassignment NPD
• Henry Ford Urgent Care

  dba Henry Ford GoHealth Urgent Care

  • Urgent Care Clinic/Center
  • Detroit, MI
  • NPI 1184389876

  Nurse Practitioner

  Medicare reassignment NPD
• Hillsdale Emergency Physicians, P.C.

  • Emergency Medicine Physician
  • Hillsdale, MI
  • NPI 1669018206

  Nurse Practitioner

  Medicare reassignment NPD
• Ihp Mi Emergency Medicine PLLC

  • Emergency Medicine Physician
  • Garden City, MI
  • NPI 1861147456
  Medicare reassignment NPD
• Independent Emergency Physicians, P.C.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Southfield, MI
  • NPI 1780791343
  Medicare reassignment NPD
• Jackson Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Jackson, MI
  • NPI 1528643723
  Medicare reassignment NPD
• Jawad a Shah, MD PC

  • Specialist
  • Flint, MI
  • NPI 1942402391
  Medicare reassignment NPD

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

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1356093553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FORD PL STE 3A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753",
            "telephone_number": "517-205-7836"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25325 Ford Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481281086",
            "country_code": "US",
            "telephone_number": "313-887-7774",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5446 Bingham St",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481263306",
            "country_code": "US",
            "telephone_number": "313-358-0203",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2799 W Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482022608",
            "country_code": "US",
            "telephone_number": "800-653-6568",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAZLOUM",
        "first_name": "KEFAH",
        "middle_name": "ABBAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-19",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704341497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew May, OTR
• Carissa J May, MD
• Hillary 'Daphne' Lynn Mayer
• Rebecca Kay Mayo
• Caralyn E Mayros
• Erin E. Mazur
• Michelle McAllister
• Tristan Danielle McBain, LLPC
• Rylee Marie McBean
• Christian L McCaslin, LPC, MA

• Family Nurse Practitioner in Jackson, MI
• Providers in Jackson, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; 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.