Jim Zivan Tavrazich

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501002600 Issued in MI

Practice address

22777 W 11 Mile Rd FL PT2
Southfield, MI 48033-2152

Phone

(248) 386-5270

NPI assigned

Mar 1, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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": "1519862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1609378082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2762 BRADY DR",
            "city": "BLOOMFIELD TOWNSHIP",
            "state": "MI",
            "postal_code": "483041725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22777 W 11 MILE RD FL PT2",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480332152",
            "telephone_number": "248-386-5270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVRAZICH",
        "first_name": "JIM",
        "middle_name": "ZIVAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-01",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501002600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jtavrazich13221@direct.hfhs.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "22777 W 11 Mile Rd Fl Pt2",
            "city": "Southfield",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480332152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alma J Tate-Anderson, LMSW
• Jayme Lynn Tate, RBT
• Renay Taub, RPH
• Breanna Taurence, NURSE PRACTITIONER
• Colleen Marie Tavor, MA, LPC, NCC, CCTP
• Leah Tawil, M.S.
• Viviane Nicole Tawile, LMSW
• Tayler Taylor LLC
• Taylor Diagnostic Imaging Inc
• Taylor Special Care Services

• Physical Therapist in Southfield, MI
• Providers in Southfield, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.

Verify at the official NPI Registry.