Sawsan Bazzi-Ismail

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F02191376 Issued in MI

Practice address

625 Kenmoor Ave SE Ste 301
Grand Rapids, MI 49546-2395

Phone

(616) 229-2935

NPI assigned

Apr 16, 2019

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1508429507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24627 ROUGE RIVER DR",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481271765",
            "telephone_number": "313-522-9246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 KENMOOR AVE SE STE 301",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462395",
            "telephone_number": "616-229-2935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZZI-ISMAIL",
        "first_name": "SAWSAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-16",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "F02191376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deanna Nicole Bazan
• Garrett David Bazany, PA-C
• Sophia G Bazany, PT, DPT
• Jennifer Bazner, M.A., LPC
• Kaylee Bazuin
• Aida Jamal Bazzi, PHARM D. CANDIDATE
• Alexa Renee Bazzi
• BC Price Professional Services LLC
• Gayle Beach
• Grant Lawson Beach

• Family Nurse Practitioner in Grand Rapids, MI
• Providers in Grand Rapids, 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 Sep 1, 2022; 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.