NPIMap

Individual provider Active NPI

Mohammed Khorram Joz, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Ann Arbor, MI
National Provider Identifier
1407528672
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704252327 Issued in MI
Practice address
455 E Eisenhower Pkwy Ste 300-1016
Ann Arbor, MI 48108-3356
Phone
(248) 983-1070
Fax
(248) 780-3805
NPI assigned
Oct 5, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704252327 MI Primary

Addresses

Primary practice location

455 E Eisenhower Pkwy Ste 300-1016
Ann Arbor, MI 48108-3356

Mailing address

455 E Eisenhower Pkwy Ste 300-1016
Ann Arbor, MI 48108-3356
Phone (248) 983-1070

Other practice location 1

3830 Packard St Ste 110
Ann Arbor, MI 48108-2051
Phone (248) 983-1070

Other practice location 2

6549 Town Center Dr Ste A
Clarkston, MI 48346-4824
Phone (800) 395-3223

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Alpha Home Healthcare Services, Inc. Current Accepting new patients
Ez Telepsych LLC Psychiatric/Mental Health CurrentSince Dec 17, 2023 Accepting new patients
Community Physicians Inc Current Accepting new patients
Fine Touch Home Care Inc PastSince Nov 27, 2006 Accepting new patients

Locations

3830 Packard St
Ste 110
Ann Arbor, MI 48108
Phone (734) 418-6956

455 E Eisenhower Pkwy
Ste 3001016
Ann Arbor, MI 48108
Phone (248) 983-1070

Organizations & group practices 4

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": "1633392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1407528672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 E EISENHOWER PKWY STE 300-1016",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481083356",
            "telephone_number": "248-983-1070",
            "fax_number": "248-780-3805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 E EISENHOWER PKWY STE 300-1016",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481083356",
            "telephone_number": "248-983-1070",
            "fax_number": "248-780-3805"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3830 Packard St Ste 110",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481082051",
            "country_code": "US",
            "telephone_number": "248-983-1070",
            "fax_number": "248-780-3805",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6549 Town Center Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Clarkston",
            "state": "MI",
            "postal_code": "483464824",
            "country_code": "US",
            "telephone_number": "800-395-3223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOZ",
        "first_name": "MOHAMMED",
        "middle_name": "KHORRAM",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-05",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704252327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 18, 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.

Verify at the official NPI Registry.