Jannatul Fardawsy

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704328478 Issued in MI

Practice address

9632 Conant St
Hamtramck, MI 48212-3305

Phone

(313) 871-1912

NPI assigned

Mar 23, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Childrens Clinic of Michigan PLLC

  • Specialist
  • Hamtramck, MI
  • NPI 1912161134
  NPD (past)
• Delta Primary & Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Warren, MI
  • NPI 1881087351
  NPD (past)

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1821674540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9632 CONANT ST",
            "city": "HAMTRAMCK",
            "state": "MI",
            "postal_code": "482123305",
            "telephone_number": "313-871-1912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9632 CONANT ST",
            "city": "HAMTRAMCK",
            "state": "MI",
            "postal_code": "482123305",
            "telephone_number": "313-871-1912"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27122 Dequindre Rd",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "MI",
            "postal_code": "480923537",
            "country_code": "US",
            "telephone_number": "586-393-5922",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2627 Holbrook St",
            "address_purpose": "LOCATION",
            "city": "Hamtramck",
            "state": "MI",
            "postal_code": "482123480",
            "country_code": "US",
            "telephone_number": "313-308-2501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARDAWSY",
        "first_name": "JANNATUL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-23",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "F12200115",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "F12200115",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704328478",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "F12200115",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704328478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Health Center & Rehab Inc
• Family Medical Care PLC
• Family Medical Clinic PC
• Faizeh Abdelkareem Faouri, PSYCHOLOGIST LLP
• Mariem Adnan Faraj
• Nuzma Farheen
• Omar Yehia Fatteh, PHARMD
• Lemuel J Fisher, CHW
• Five Lakes Medical Group PLLC
• Srilaxmi Gandla, PT

• Nurse Practitioner in Hamtramck, MI
• Providers in Hamtramck, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.