ASCENSION PROVIDENCE HOSPITAL (NPI# 1003892092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003892092 |
| Entity Type | Organization |
| Organization Name | ASCENSION PROVIDENCE HOSPITAL |
| Other Organization Name | PROVIDENCE-PROVIDENCE PARK HOSPITAL |
| Practice Address |
16001 W. 9 Mile Road Southfield MI 48075-4818 |
| Practice Telephone | 2433493000 |
| Practice Fax Number | 2487460384 |
| Mailing Telephone | 2433493000 |
| Mailing Fax Number | 2487460384 |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2019-03-29 |
| Authorized Official Name | JOSEPH HURSHE (PRESIDENT) |
| Authorized Official Telephone | 2433493400 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BLUE CROSS | 21277 | 01 |
| MI | 1557875 | 05 | |
| MI | BLUE CROSS | 20277 | 01 |
| Other Name | Type Code |
|---|---|
| Providence Hospital and Medical Centers | Doing Business As Name - Organization |
| Providence-Providence Park Hospital | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225093776 | Ascension Providence Hospital | Nuclear Medicine | 2800 Livernois Rd, Blgd D Suite 500, Troy, MI 48083-1215 | 2006-04-19 |
| 1043385909 | Ascension Providence Hospital | General Acute Care Hospital | 47601 Grand River Ave, Novi, MI 48374-1233 | 2006-11-22 |
| 1851339196 | Ascension Providence Hospital | Nurse Anesthetist, Certified Registered | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2006-06-02 |
| 1003871062 | Ascension Providence Hospital | Pediatrics | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2006-04-20 |
| 1629033683 | Ascension Providence Hospital | Internal Medicine | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2006-04-20 |
| 1265497226 | Ascension Providence Hospital | Pediatrics | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2006-04-20 |
| 1619932670 | Ascension Providence Hospital | Psychiatry & Neurology | 16001 W 9 Mile Rd, Physician Billing Services, Southfield, MI 48075-4818 | 2006-04-20 |
| 1528023587 | Ascension Providence Hospital | Psychologist | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2006-04-20 |
| 1235194291 | Ascension Providence Hospital | Internal Medicine | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2006-04-20 |
| 1144285107 | Ascension Providence Hospital | General Practice | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2006-04-20 |
| Street Address |
16001 W. 9 MILE ROAD |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48075-4818 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992369060 | Sandra Tallat-farmand Haider | Student in an Organized Health Care Education/Training Program | 16001 W. 9 Mile Road, 2nd Floor De Paul, Southfield, MI 48075-4818 | 2019-04-24 |
| 1629631965 | Rachelle Lynn Leveille | Podiatrist | 16001 W. 9 Mile Road, 2nd Floor Depaul, Southfield, MI 48075-4818 | 2019-04-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851900054 | K&b Medical Wigs, LLC | Durable Medical Equipment & Medical Supplies | 16250 Northland Dr. Ste 221, Southfield, MI 48075 | 2020-07-24 |
| 1790300390 | Julian Jeberaeel | Radiology | 2250 Providence, Southfield, MI 48075 | 2020-06-10 |
| 1265056410 | Husein Yusuf Husein | Podiatrist | Ascension Providence Hospital Southfield Campus, 16001 W. Nine Mile Rd. Depaul 2nd Floor, Southfield, Mi, MI 48075 | 2020-06-03 |
| 1952945420 | Paris Straughter | Nurse Practitioner | 18438 Onyx St, Southfield, MI 48075 | 2019-10-29 |
| 1811467657 | Medicine Man Medical, Pllc | Physical Medicine & Rehabilitation | 25130 Southfield Road, Suite #210, Southfield, MI 48075 | 2018-12-04 |
| 1447725528 | Rommel Ramos Perez | Physical Therapist | 26017 Greenfield Rd., Southfield, MI 48075 | 2018-10-04 |
| 1073009627 | Jacqueline Venora Goodgame | Licensed Practical Nurse | 4000 Town Ctr, Southfield, MI 48075 | 2018-07-06 |
| 1043712532 | Hollie Marie Maltese | Physical Therapy Assistant | 22255 Greenfiled 118, Southfield, MI 48075 | 2018-03-01 |
| 1932601481 | Katie Marie Mccormack | Occupational Therapist | 16001 West Nine Mile Rd., Southfield, MI 48075 | 2018-03-01 |
| 1801304241 | Absolute Hc LLC | Physical Therapist | 23461 Greenfield Rd Ste 200b, Southfield, MI 48075 | 2018-01-19 |
| Find all providers in zip 48075 | ||||
| Taxonomy Code | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982983094 | Senior Psychiatric Hospitalists of Mi, Pllc | Psychiatric Unit | 3572 Empire State Dr, Canton, MI 48188-8202 | 2011-08-07 |
| 1841591260 | Growing Counseling Services, LLC | Psychiatric Unit | 446 Tobin Dr, 311, Inkster, MI 48141-3557 | 2010-11-17 |
| 1548426372 | Gloria Carr | Psychiatric Unit | 404 Velvet Ave, Portage, MI 49002-7050 | 2008-07-31 |
| 1356370522 | Advanced Counseling Services | Psychiatric Unit | 6223 N Canton Center Rd, Ste. 210, Canton, MI 48187-2696 | 2006-07-01 |
| 1669431292 | Edward W. Sparrow Hospital Association | Psychiatric Unit | 1210 W. Saginaw Street, Lansing, MI 48912-1999 | 2006-03-22 |
| 1831179837 | Mclaren Greater Lansing | Psychiatric Unit | 2727 S Penn Ave, Lansing, MI 48910-3488 | 2006-01-18 |
| 1265426704 | Healthsource Saginaw Inc | Psychiatric Unit | 3340 Hospital Rd, Saginaw, MI 48603-9622 | 2005-09-09 |
| 1407480247 | Prime Healthcare Services - Garden City, LLC | Psychiatric Unit | 6245 Inkster Rd, Garden City, MI 48135-4001 | 2020-03-02 |
| 1255748307 | Henry Ford Health System | Psychiatric Unit | 1 Ford Pl, Detroit, MI 48202-3450 | 2014-07-21 |
| 1114348695 | Common Ground | Psychiatric Unit | 461 W Huron St, Pontiac, MI 48341-1601 | 2013-12-30 |
| Find all providers with the same taxonomy | ||||
| City | SOUTHFIELD |
| Zip Code | 48075 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.