Active NPI
Julie M Izzard, CNM
- Advanced Practice Midwife
- Dearborn, MI
National Provider Identifier
1770548331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- 4704194315
- Practice address
- 18101 Oakwood Blvd
Dearborn, MI 48124-4089 - Phone
- (313) 593-7500
- Fax
- (313) 593-8840
- NPI assigned
- Apr 18, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Advanced Practice Midwife | 367A00000X | 4704194315 | MI | Primary |
Addresses
Primary practice location
18101 Oakwood Blvd
Dearborn, MI 48124-4089
Mailing address
26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Phone (947) 522-0307
Other practice location 1
1114 Charlevoix Ave
Petoskey, MI 49770-9701
Phone (231) 439-9700
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104304265 | Medicaid | MI | |
| 383445481 | Other | MI | COMMERCIAL INS |
| 420B41027 | Other | MI | BLUE CROSS BLUE SHIELD |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jizzard119921@direct.beaumont.edu |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Midwife
Interoperability endpoints
- jizzard1239297@epic00.shdirect.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657843200000",
"number": "1770548331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26901 BEAUMONT BLVD STE 3D",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480333849",
"telephone_number": "947-522-0307",
"fax_number": "947-522-0307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18101 OAKWOOD BLVD",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481244089",
"telephone_number": "313-593-7500",
"fax_number": "313-593-8840"
}
],
"practiceLocations": [
{
"address_1": "1114 Charlevoix Ave",
"address_purpose": "LOCATION",
"city": "Petoskey",
"state": "MI",
"postal_code": "497709701",
"country_code": "US",
"telephone_number": "231-439-9700",
"fax_number": "231-439-9709",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "IZZARD",
"first_name": "JULIE",
"middle_name": "M",
"credential": "CNM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-18",
"last_updated": "2022-07-15",
"certification_date": "2022-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "MI",
"license": "4704194315",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "104304265",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMERCIAL INS",
"identifier": "383445481",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "420B41027",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jizzard119921@direct.beaumont.edu",
"affiliation": "N",
"address_1": "18101 Oakwood Blvd",
"city": "Dearborn",
"state": "MI",
"country_code": "US",
"postal_code": "481244089",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.