Active NPI
Issa Basem Kakish, PHARMD
- Pharmacist
- Grosse Pointe, MI
National Provider Identifier
1497325260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302412991
- Practice address
- 17120 Kercheval Ave
Grosse Pointe, MI 48230-1661 - Phone
- (313) 886-3300
- NPI assigned
- Jun 25, 2021
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302412991 | MI | Primary |
Addresses
Primary practice location
17120 Kercheval Ave
Grosse Pointe, MI 48230-1661
Mailing address
2229 Bernice Ave
Warren, MI 48091-1039
Phone (586) 216-1023
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302412991 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624579200000",
"number": "1497325260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2229 BERNICE AVE",
"city": "WARREN",
"state": "MI",
"postal_code": "480911039",
"telephone_number": "586-216-1023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17120 KERCHEVAL AVE",
"city": "GROSSE POINTE",
"state": "MI",
"postal_code": "482301661",
"telephone_number": "313-886-3300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAKISH",
"first_name": "ISSA",
"middle_name": "BASEM",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-25",
"last_updated": "2021-06-25",
"certification_date": "2021-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302412991",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grosse Pointe, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.