Individual provider Active NPI

Mirna A Khanafer

  • Family Nurse Practitioner
  • Canton, MI
National Provider Identifier
1689274482
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704321482 Issued in MI
Practice address
6300 N Haggerty Rd Ste 200
Canton, MI 48187-4472
Phone
(734) 981-8181
NPI assigned
Oct 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704321482 MI Primary

Addresses

Primary practice location

6300 N Haggerty Rd Ste 200
Canton, MI 48187-4472

Mailing address

1826 N Highland St
Dearborn, MI 48128-1289
Phone (313) 820-3951

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

State licenses

LicenseStateTypeSpecialty
4704321482MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Women'S Care, PLLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mirna.khanafer.1@15822.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/15822/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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": "1603929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1689274482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1826 N HIGHLAND ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481281289",
            "telephone_number": "313-820-3951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 N HAGGERTY RD STE 200",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481874472",
            "telephone_number": "734-981-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHANAFER",
        "first_name": "MIRNA",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-29",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704321482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; 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.