Marrisa Modell

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

43825 Michigan Ave
Canton, MI 48188-2551

Phone

(734) 397-3088

Fax

(734) 397-0078

NPI assigned

Dec 9, 2024

Sex

Unspecified or another gender identity

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1733702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1942016506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10958 OAK LN APT 6216",
            "city": "VAN BUREN TOWNSHIP",
            "state": "MI",
            "postal_code": "481114377",
            "telephone_number": "734-720-2933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43825 MICHIGAN AVE",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481882551",
            "telephone_number": "734-397-3088",
            "fax_number": "734-397-0078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODELL",
        "first_name": "MARRISA",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2024-12-09",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joyce M Mitchell, MD
• Karen Elizabeth Mitchell
• Sytriss Lasean Mitchell, LPN
• Subham Mitra, RN
• Francesca Leanne Mitrano
• Mohamad Bazzi M D P C
• Syeda Yasmeen Mohammad, PSY.D.LP
• Wisal S Mohd, RPH
• Momentum Care
• Mommy & Mentors Mihp, LLC

• Student in an Organized Health Care Education/Training Program in Canton, MI
• Providers in Canton, MI by specialty
• Student in an Organized Health Care Education/Training Program in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; 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.