George Ibrahim Fakhouri, DO

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

5101025718 Issued in MI

Practice address

36385 Harper Ave
Clinton TWP, MI 48035-2958

Phone

(586) 684-1900

NPI assigned

Jul 3, 2018

Last updated

Jan 9, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Sports MedicineAlso: Osteopathic Manipulative Medicine

Education

Michigan State University College of Osteopathic Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michigan MSK Medicine PLLCGroup PAC ID 9234546896, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• McLaren Macomb Hospital, Mount Clemens, MI, CCN 230227

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gfakhouri413172@direct.hfhs.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Michigan MSK Medicine PLLC

  • Neuromusculoskeletal Medicine & OMM Physician
  • Clinton Township, MI
  • NPI 1578148375

  Neuromusculoskeletal Medicine, Sports Medicine

  Medicare reassignment Care Compare group NPD
• Edward W. Sparrow Hospital Association

  dba Sparrow Regional Children's Center

  • Pediatrics Physician
  • Lansing, MI
  • NPI 1831139088
  Medicare reassignment NPD
• Edward W Sparrow Hospital Association

  dba University of Michigan Health-Sparrow

  • Adult Health Nurse Practitioner
  • Lansing, MI
  • NPI 1265220438

  Family Medicine

  NPD
• Edward W. Sparrow Hospital Association

  dba Sparrow Family Medicine Residency Central

  • Family Medicine Physician
  • Mason, MI
  • NPI 1083668545
  NPD

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

• McLaren Macomb

  • Psychiatric Hospital Unit
  • Shelby Township, MI
  • NPI 1184206385
  Care Compare affiliation
• McLaren Macomb

  • General Acute Care Hospital
  • Mount Clemens, MI
  • NPI 1316938327
  Care Compare affiliation

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

{
    "created_epoch": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1992291900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36385 HARPER AVE",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480352958",
            "telephone_number": "586-684-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36385 HARPER AVE",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480352958",
            "telephone_number": "586-684-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAKHOURI",
        "first_name": "GEORGE",
        "middle_name": "IBRAHIM",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-03",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "MI",
            "license": "5101025718",
            "primary": false
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "MI",
            "license": "5101025718",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MI",
            "license": "5101025718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Ewald, LMSW
• Tricia Lynn Fabbri, NP
• Adam Mohamed Fahs
• Heather Lee Fairless, O.D.
• Ben Fajardo, M.D.
• Family Chiropractor P.C.
• Family Medicine Associates of Macomb PC
• Family Practice Physicians
• Fedor Opochinsky M.D.
• Christina M. Felcyn, MA, LPC, NCC

• Sports Medicine (Family Medicine) Physician in Clinton TWP, MI
• Providers in Clinton TWP, MI by specialty
• Sports Medicine (Family Medicine) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.