NPIMap

Individual provider Active NPI

Nadim Kanaan

  • Internal Medicine Physician
  • Midland, MI
National Provider Identifier
1871117440
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301509400 Issued in MI
Practice address
4000 Wellness Dr
Midland, MI 48670-5303
Phone
(989) 839-1644
Fax
(989) 839-3029
NPI assigned
May 29, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4351047169 MI
Internal Medicine Physician 207R00000X 4301509400 MI Primary

Addresses

Primary practice location

4000 Wellness Dr
Midland, MI 48670-5303

Mailing address

4000 Wellness Dr
Midland, MI 48670-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230522000589 MI Practitioner - Internal Medicine 3577984970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mymichigan Medical GroupGroup PAC ID 4981501939, 174 clinicians

Practice addresses (Care Compare)

4000 Wellness Dr
Midland, MI 48670-0001
Phone (989) 839-1644

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4301509400MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Group Internal Medicine CurrentSince Jul 18, 2023 Accepting new patients
Mymichigan Medical Group Current Accepting new patients
Mymichigan Medical Center Alpena CurrentSince Jul 18, 2023 Accepting new patients
Mymichigan Medical Center Midland Past Accepting new patients

Locations

609 Quarter St
Gladwin, MI 48624
Phone (989) 246-6371

815 N Clare Ave
Harrison, MI 48625
Phone (989) 539-4096

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

Interoperability endpoints

  • Direct secure messaging: nkanaan90579@direct.covenanthealthcare.com

Organizations & group practices 4

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1871117440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 WELLNESS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486700001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 WELLNESS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486705303",
            "telephone_number": "989-839-1644",
            "fax_number": "989-839-3029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANAAN",
        "first_name": "NADIM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-29",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4351047169",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301509400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.