ST JOHN MACOMB OAKLAND HOSPITAL (NPI# 1033376538) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033376538 |
| Entity Type | Organization |
| Organization Name | ST JOHN MACOMB OAKLAND HOSPITAL |
| Practice Address |
7733 E Jefferson Ave Detroit MI 48214-3707 |
| Mailing Address |
28000 Dequindre Rd Warren MI 48092-2468 |
| Practice Telephone | 3134994000 |
| Mailing Telephone | 5867530275 |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2008-06-25 |
| Authorized Official Name | RANDOLPH KRUMMLER (VP FINANCE) |
| Authorized Official Telephone | 5865735910 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | ||
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BLUE CROSS | 18200032 | 01 |
| BLUE CROSS | 0H26326 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578891966 | St John Macomb Oakland Hospital | Audiologist | 11800 E 12 Mile Rd, Suite 1829, Warren, MI 48093-3472 | 2009-11-24 |
| 1013174655 | St John Macomb Oakland Hospital | Pathology | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2008-05-21 |
| 1326205964 | St John Macomb Oakland Hospital | Emergency Medicine | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2008-05-21 |
| 1811154628 | St John Macomb Oakland Hospital | Pediatrics | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2008-05-20 |
| 1427215235 | St John Macomb Oakland Hospital | Radiology | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2008-05-20 |
| 1770750309 | St John Macomb Oakland Hospital | General Acute Care Hospital | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2008-05-13 |
| 1811102742 | St John Macomb Oakland Hospital | Pathology | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2007-05-14 |
| Street Address |
7733 E JEFFERSON AVE |
| City | DETROIT |
| State | MI |
| Zip Code | 48214-3707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881681955 | Patricia Barszenski | Nurse Practitioner | 7733 E Jefferson Ave, 1350, Detroit, MI 48214-3707 | 2005-10-04 |
| 1790030690 | Ccla9, LLC | Skilled Nursing Facility | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2012-07-17 |
| 1295018745 | Ccla 9 LLC | Skilled Nursing Facility | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2011-09-21 |
| 1629216007 | Lakshmi Subba Nellutla | Family Medicine | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2009-01-23 |
| 1922257401 | Medical Resource Group | Clinic/Center | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2008-09-09 |
| 1013174655 | St John Macomb Oakland Hospital | Pathology | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2008-05-21 |
| 1326205964 | St John Macomb Oakland Hospital | Emergency Medicine | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2008-05-21 |
| 1770750309 | St John Macomb Oakland Hospital | General Acute Care Hospital | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2008-05-13 |
| 1245406875 | Dr. Kerry L. Kole PC | Surgery | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2008-05-04 |
| 1871783530 | Medical Resource Group | Emergency Medicine | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2007-07-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376042325 | Tamara Wesley | Registered Nurse | 9000 E. Jefferson Apt 28-14, Detroit, MI 48214 | 2018-02-06 |
| 1720534381 | Birth Beautiful Detroit | Clinic/Center | 1086 Baldwin, Detroit, MI 48214 | 2016-09-01 |
| 1225402886 | Steven Doyle Whatley I | Counselor | 1423 Field Ave., Adult Well Being Services, Detroit, MI 48214 | 2015-11-19 |
| 1255587945 | Andrew Avery | Internal Medicine | 7733 East Jefferson Ave, Detroit, MI 48214 | 2008-08-13 |
| 1639330210 | Nicole Lashawn Greene | Specialist | 4533 St Clair St, Detroit, MI 48214 | 2008-06-17 |
| 1629299433 | Alan R Faber Jr. | Dentist | 8191 E Jefferson Ave, Detroit, MI 48214 | 2007-05-01 |
| 1518188598 | Mary F Bridges | Psychiatry & Neurology | 8120 East Jefferson #3l, Detroit, MI 48214 | 2007-05-01 |
| 1053439737 | Geraldine Etella Davis | Counselor | 3840 Fairview St., Detroit, MI 48214 | 2007-03-27 |
| 1639203482 | Detroit-macomb Hospital Corporation | Advanced Practice Midwife | 7815 E. Jefferson, Detroit, MI 48214 | 2007-03-15 |
| 1033275441 | Anesha Amor Rouse | Physical Therapy Assistant | 7633 E. Jefferson Ave, Suite 170, Detroit, MI 48214 | 2006-12-29 |
| Find all providers in zip 48214 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831539469 | Bayoan Manuel Ramos-parra | Internal Medicine | 311 Mack Ave Ste 21025, Detroit, MI 48201-2466 | 2013-06-27 |
| 1972796373 | Mark K. Lahiri | Internal Medicine | 2799 W Grand Blvd., Detroit, MI 48202 | 2007-08-20 |
| 1619181427 | Aiden Abidov | Internal Medicine | 4160 John R St Ste 804, Detroit, MI 48201-2014 | 2007-05-10 |
| 1174740229 | Benjamin A Burroughs | Internal Medicine | 2799 W. Grand Blvd, K-14, Henry Ford Cardiac Surgery Pofessional Building, Detroit, MI 48202 | 2007-04-19 |
| 1225151061 | Dee Dee Wang | Internal Medicine | 2799 W Grand Blvd # K-14, Detroit, MI 48202-2608 | 2007-04-09 |
| 1831267376 | Arif Husain Hakim | Internal Medicine | 14500 W Mcnichols Rd, Detroit, MI 48235-3904 | 2006-12-01 |
| 1528145679 | Zeia Casab Rueda | Internal Medicine | 5662 W Vernor Hwy, Detroit, MI 48209-2158 | 2006-11-01 |
| 1841398880 | Narsimha Reddy Gottam | Internal Medicine | 7633 E Jefferson Ave., Suite #360, Detroit, MI 48214-3732 | 2006-09-21 |
| 1033221056 | Khaled M Sleik | Internal Medicine | 311 Mack Ave Ste 2101, Detroit, MI 48201-2466 | 2006-08-31 |
| 1992817076 | Pritpal Singh Puri | Internal Medicine | Harper Hospital 3990john R, C/o Medical Affairs, Detroit, MI 48201-2403 | 2006-08-31 |
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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.