ST. JOHN HOSPITAL AND MEDICAL CENTER (NPI# 1437439502) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437439502 |
| Entity Type | Organization |
| Organization Name | ST. JOHN HOSPITAL AND MEDICAL CENTER |
| Practice Address |
22151 Moross Rd Pb I Suite 332 Detroit MI 48236-2167 |
| Mailing Address |
21441 Sloan Dr Apt. # 203 B Harper Woods MI 48225-2428 |
| Practice Telephone | 3133437849 |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2011-08-22 |
| Authorized Official Name | ARMANDO JOSE SALAZAR (M.D.) |
| Authorized Official Telephone | 3056131911 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | AS3062508-28 | MI | Hospitals |
| 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 |
| 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 |
| 1386892834 | St. John Hospital and Medical Center | Family Medicine | 21099 Masonic Blvd, Saint Clair Shores, MI 48082-1045 | 2008-09-08 |
| Street Address |
22151 MOROSS RD PB I SUITE 332 |
| City | DETROIT |
| State | MI |
| Zip Code | 48236-2167 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366440463 | Christine Ann Crader | Internal Medicine | 22151 Moross Rd, Detroit, MI 48236-2167 | 2005-07-12 |
| 1467078857 | Anirudh Kotha | Student in an Organized Health Care Education/Training Program | 22151 Moross Rd, Ste 214, Detroit, MI 48236 | 2020-06-22 |
| 1386147981 | Carla Freigeh | Physician Assistant | 22151 Moross Rd, Detroit, MI 48236-2167 | 2018-03-10 |
| 1245738822 | Stacey Alise Joiner | Counselor | 22151 Moross Rd, Detroit, MI 48236-2167 | 2018-01-29 |
| 1730618158 | Victoria Elizabeth Simmons | Surgery | 22151 Moross Rd, Suite 214, Detroit, MI 48236 | 2017-06-08 |
| 1902356272 | Jisha Dudeesh | Nurse Practitioner | 22151 Moross Rd, Professional Building One, Detroit, MI 48236-2167 | 2016-10-10 |
| 1841740792 | Celia Shallal | Social Worker | 22151 Moross Rd, Pb1, Detroit, MI 48236-2167 | 2016-10-04 |
| 1841668308 | Moayad Tarboush | Student in an Organized Health Care Education/Training Program | 22151 Moross Rd, Detroit, MI 48236-2167 | 2015-09-14 |
| 1285023226 | Lauren Krist | Nurse Practitioner | 22151 Moross Rd, Detroit, MI 48236-2167 | 2015-01-14 |
| 1194122937 | Patricia Vassallo | Nurse Practitioner | 22151 Moross Rd, Pb 2 Suite 209, Detroit, MI 48236-2167 | 2014-11-21 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093323966 | Khairya Fatouh | Pathology | 22101 Morros Road, Pathology Department, Detroit, Detroit, MI 48236 | 2020-07-16 |
| 1134744998 | Harish Harry Gidda | Internal Medicine | 22201 Moross Rd, Suite 50, Detroit, MI 48236 | 2020-06-08 |
| 1770107443 | Arshan Ali Khan | Internal Medicine | 22101 Moross Rd, Suite 50, Detroit, MI 48236 | 2020-05-29 |
| 1750901658 | Annika Van Wieren | Emergency Medicine | 22101 Moross Road, Emergency Department, Detroit, MI 48236 | 2020-04-21 |
| 1801449483 | Ishaq Azeem Asghar | Student in an Organized Health Care Education/Training Program | 22101 Moross Road, Pathology Department, Detroit, MI 48236 | 2019-07-22 |
| 1295290443 | Ascension St. John Hospital | Dietitian, Registered | 22201 Moross, Ste. 270, Detriot, MI 48236 | 2019-02-01 |
| 1548747413 | Abiodun Adenuga Adefarasin | Pharmacist | 20746 Mack Avenue, Gross Pointe Woods, MI 48236 | 2018-07-24 |
| 1629564042 | Hamza H Khan | Student in an Organized Health Care Education/Training Program | 22201 Moross, Professional Building 2, Suite 70, Detroit, MI 48236 | 2018-07-09 |
| 1235631664 | David Lee Williams | Physical Therapist | 159 Kercheval Avenue, Grosse Pointe Farms, MI 48236 | 2018-03-01 |
| 1164979720 | Memphie Morgan | Licensed Practical Nurse | 91527 Cheshire St., Grosse Pointe, MI 48236 | 2016-09-01 |
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| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
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|---|---|---|---|---|
| 1740899194 | Ascension Michigan Employer Solutions LLC | General Acute Care Hospital | 5555 Conner St Ste 2818, Detroit, MI 48213-3448 | 2020-07-30 |
| 1043551146 | Detroit Medical Center | General Acute Care Hospital | 3990 John R Rd, Detroit, MI 48201 | 2013-03-14 |
| 1346511151 | Sara Goldgraben | General Acute Care Hospital | 540 E. Canfield, Department of Radiation Oncology, Detroit, MI 48201 | 2012-01-25 |
| 1174837686 | Detroit Medical Center | General Acute Care Hospital | 4201 St. Antoine- 6g Uhc, 6g Uhc, Detroit, MI 48201 | 2010-07-27 |
| 1922239920 | Wayne State University/detroit Medical Center | General Acute Care Hospital | 4201 Saint Antoine St # 2e, Detroit, MI 48201-2153 | 2009-08-07 |
| 1710134010 | Tetsuhiro Higashida | General Acute Care Hospital | 4201 St. Antoine Suite 6e, Detroit, MI 48201 | 2008-08-19 |
| 1487792818 | Detroit Hope Hospital | General Acute Care Hospital | 801 Virgina Park, Detroit, MI 48202 | 2007-02-01 |
| 1134266687 | Detroit Hope Hospital | General Acute Care Hospital | 801 Virginia Park, Detroit, MI 48202 | 2007-01-31 |
| 1669400305 | Ltac Hospital Detroit, LLC | General Acute Care Hospital | 801 Virginia Park St, Third Floor, Detroit, MI 48202-1925 | 2006-06-29 |
| 1043755788 | Barbara Ann Karmanos Cancer Center | General Acute Care Hospital | 4100 John R St, Detroit, MI 48201-2013 | 2017-01-05 |
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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.