ST. JOHN HOSPITAL AND MEDICAL CENTER (NPI# 1386892834) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386892834 |
| Entity Type | Organization |
| Organization Name | ST. JOHN HOSPITAL AND MEDICAL CENTER |
| Other Organization Name | MASONIC URGENT CARE CENTER |
| Practice Address |
21099 Masonic Blvd Saint Clair Shores MI 48082-1045 |
| Practice Telephone | 5862966213 |
| Practice Fax Number | 5862968180 |
| Mailing Telephone | 5862966213 |
| Mailing Fax Number | 5862968180 |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2012-12-12 |
| Authorized Official Name | JENNIFER JOHNSON (DIRECTOR) |
| Authorized Official Telephone | 5862284560 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | MI | Allopathic & Osteopathic Physicians | |
| Y | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
MI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBS GROUP NUMBER | 700E014700 | 01 |
| MI | BCBS GROUP NUMBER | 700E034110 | 01 |
| MI | BCBS GROUP NUMBER | 700E031610 | 01 |
| Other Name | Type Code |
|---|---|
| Masonic Urgent Care Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851362586 | St. John Hospital and Medical Center | General Acute Care Hospital | 26755 Ballard Road, Harrison Township, MI 48045 | 2006-01-31 |
| 1801866942 | St. John Hospital and Medical Center | Rehabilitation Unit | 26755 Ballard St, Harrison Twp, MI 48045-2419 | 2006-01-23 |
| 1285902627 | St. John Hospital and Medical Center | Audiologist | 21000 E 12 Mile Rd, Suite 111, Saint Clair Shores, MI 48081-1116 | 2011-12-13 |
| 1437439502 | St. John Hospital and Medical Center | General Acute Care Hospital | 22151 Moross Rd, Pb I Suite 332, Detroit, MI 48236-2167 | 2011-08-22 |
| 1679881510 | St. John Hospital and Medical Center | Internal Medicine | 19901 E 10 Mile Rd, Saint Clair Shores, MI 48080-1069 | 2010-09-14 |
| 1376854661 | St. John Hospital and Medical Center | Nurse Practitioner | 2800 Livernois Rd, Suite 500, Troy, MI 48083-1215 | 2010-07-01 |
| 1750517678 | St. John Hospital and Medical Center | General Acute Care Hospital | 22101 Moross Rd, Detroit, MI 48236-2148 | 2009-06-05 |
| 1053550996 | St. John Hospital and Medical Center | Clinic/Center | 22201 Moross Rd, Professional Building Two, Suite 50, Detroit, MI 48236-2169 | 2009-02-17 |
| 1346487550 | St. John Hospital and Medical Center | Audiologist-Hearing Aid Fitter | 22101 Moross Rd, Detroit, MI 48236-2148 | 2009-01-09 |
| 1982841193 | St. John Hospital and Medical Center | Audiologist-Hearing Aid Fitter | 22101 Moross Rd, Detroit, MI 48236-2148 | 2009-01-09 |
| Street Address |
21099 MASONIC BLVD |
| City | SAINT CLAIR SHORES |
| State | MI |
| Zip Code | 48082-1045 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376503151 | Rachel Eileen O'byrne | Family Medicine | 21099 Masonic Blvd, Saint Clair Shores, MI 48082-1045 | 2006-03-24 |
| 1649708959 | Hany Eraqi | Family Medicine | 21099 Masonic Blvd, Saint Clair Shores, MI 48082-1045 | 2017-05-31 |
| 1376926865 | Jeanette Elizabeth Wilson | Family Medicine | 21099 Masonic Blvd, Saint Clair Shores, MI 48082 | 2015-07-02 |
| 1841470481 | Kwame O. Francis | Family Medicine | 21099 Masonic Blvd, Saint Clair Shores, MI 48082-1045 | 2007-11-12 |
| 1467571463 | Veena Panthangi | Family Medicine | 21099 Masonic Blvd, Saint Clair Shores, MI 48082-1045 | 2007-03-29 |
| 1699725481 | Barry Joseph Scofield | Family Medicine | 21099 Masonic Blvd, Saint Clair Shores, MI 48082-1045 | 2006-05-11 |
| 1306895065 | Chandrika Iyer | Family Medicine | 21099 Masonic Blvd, Saint Clair Shores, MI 48082-1045 | 2006-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932416476 | Maryam Torab Parhiz | Dentist | 31118 Harper Ave, St.clair Shores, MI 48082 | 2010-09-03 |
| 1558519314 | Sandra J. Glovak | Occupational Therapist | 30801 Jefferson Ave., St. Clair Shores, MI 48082 | 2008-09-05 |
| 1750597498 | Philip Salvatore Badalamenti | Dentist | 29810 Harper Ave, St Clair Shores, MI 48082 | 2007-05-16 |
| 1710025499 | Camilo Machado | Dentist | 31315 Harper Avenuw, St. Clair Shores, MI 48082 | 2007-02-02 |
| 1427126457 | Daniel M Hull | Dentist | 31549 Harper, Saint Clair Shores, MI 48082 | 2006-11-30 |
| 1679662860 | Peter Leone | Dentist | 30140 Harper Ave, Suite 200, Saint Clair Shores, MI 48082 | 2006-10-12 |
| 1417063371 | Vincent James Alongi | Dentist | 30140 Harper Suite 100, St Clair Shores, MI 48082 | 2006-08-22 |
| 1598721060 | Ilse Karger | Dentist | 29850 Harper, St Clair Shores, MI 48082 | 2006-04-25 |
| 1093714081 | Brian Anthony Arnold | Chiropractor | 31930 Harper Ave, Saint Clair Shores, MI 48082 | 2005-07-20 |
| 1619469905 | Bryan Lazzarin | Optometrist | 30120 Harper Ave, Saint Clair Shores, MI 48082 | 2018-06-01 |
| Find all providers in zip 48082 | ||||
| Taxonomy Code | 261QU0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Urgent Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891098174 | Saint Clair Shores Prompt Care Pllc | Clinic/Center | 25631 Little Mack Avenue, Suite 104, Saint Clair Shores, MI 48081-2100 | 2010-12-08 |
| 1508410168 | Associated Orthopedists of Detroit PC | Clinic/Center | 24715 Little Mack Ave Ste 100, Saint Clair Shores, MI 48080-3207 | 2019-07-31 |
| 1316350192 | Seton Health Corporation of Southeastern Michigan | Clinic/Center | 21000 E 12 Mile Rd, Suite 105, Saint Clair Shores, MI 48081-1116 | 2014-06-09 |
| 1063854941 | Medical Resource Group | Clinic/Center | 21000 E 12 Mile Rd, Suite 105, Saint Clair Shores, MI 48081-1116 | 2013-07-22 |
| 1821120551 | St John Regional Medical Urgent Care | Clinic/Center | 21000 E 12 Mile Rd, Ste 102, Saint Clair Shores, MI 48081-1116 | 2007-03-09 |
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| 1326660929 | Doctors Urgent Care Southfield | Clinic/Center | 29405 Greenfield Rd, Southfield, MI 48076-2226 | 2020-05-18 |
| 1538704218 | West Park Medical Clinic PC | Clinic/Center | 16238 W Warren Ave, Detroit, MI 48228-3701 | 2019-11-17 |
| 1225679822 | The Urgent Care PC | Clinic/Center | 170 W Genesee St Ste B, Frankenmuth, MI 48734-1305 | 2019-10-04 |
| 1508417197 | Vps of Mi Pllc | Clinic/Center | 25880 Outer Dr Ste 1, Lincoln Park, MI 48146-1553 | 2019-09-25 |
| 1356804710 | Southshore Urgent Care Pllc. | Clinic/Center | 20789 Gibraltar Rd, Brownstown Twp, MI 48183-5087 | 2019-04-11 |
| 1871054650 | Warren Urgent Care Walk-in Clinic LLC | Clinic/Center | 30736 Hoover Rd, Warren, MI 48093-2555 | 2019-03-26 |
| 1821553587 | Medpointe Urgent Care Walk In Clinic PC | Clinic/Center | 31290 Groesbeck Hwy, Fraser, MI 48026-2517 | 2019-02-07 |
| 1174088066 | Kb Care, Pllc | Clinic/Center | 4563 Washtenaw Ave Ste B, Ann Arbor, MI 48108-1011 | 2019-02-05 |
| 1700340569 | Nuch of Michigan, Inc. | Clinic/Center | 20782 Thirteen Mile Road, Roseville, MI 48375 | 2019-01-25 |
| Find all providers with the same taxonomy | ||||
| City | SAINT CLAIR SHORES |
| Zip Code | 48082 |
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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.