ST. JOHN PROVIDENCE MACOMB/OAKLAND (NPI# 1477846293) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477846293 |
| Entity Type | Organization |
| Organization Name | ST. JOHN PROVIDENCE MACOMB/OAKLAND |
| Practice Address |
11800 E 12 Mile Rd Warren MI 48093-3472 |
| Practice Telephone | 5855735300 |
| Mailing Telephone | 5855735300 |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2011-05-26 |
| Authorized Official Name | DR. BAL K GUPTA (DIRECTOR OF BEHAVIORIAL MEDICINE) |
| Authorized Official Telephone | 5865735300 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 283Q00000X | Psychiatric Hospital | 6401002292 | MI | Hospitals |
| Y | 283Q00000X | Psychiatric Hospital | 6802070800 | MI | Hospitals |
| Street Address |
11800 E 12 MILE RD |
| City | WARREN |
| State | MI |
| Zip Code | 48093-3472 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740280940 | Manisha Kaur Bajwa | Pharmacist | 11800 E 12 Mile Rd, Pharmacy Department, Warren, MI 48093-3472 | 2005-07-28 |
| 1679181986 | Roxana Lionte | Nurse Practitioner | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2020-07-22 |
| 1649893355 | Patrick Yang | Student in an Organized Health Care Education/Training Program | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2020-05-28 |
| 1831711936 | Elisheva Ellenberg | Nurse Practitioner | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2020-05-12 |
| 1427686716 | Pavan Kumar Ravipati | Student in an Organized Health Care Education/Training Program | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2020-03-31 |
| 1962038885 | Natasha Mehta | Student in an Organized Health Care Education/Training Program | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2020-03-23 |
| 1194350645 | Katherine Sara Streidl | Nurse Anesthetist, Certified Registered | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2020-03-05 |
| 1891326898 | Clara Poparad-stezar | Student in an Organized Health Care Education/Training Program | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2020-01-28 |
| 1023653797 | Lauren Ashley Shailor | Nurse Practitioner | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2019-11-16 |
| 1700428984 | Olivia Lynn Hedman | Dietitian, Registered | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2019-10-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023615986 | Toleka Regina Taylor | Nurse Anesthetist, Certified Registered | St. John Macomb Hospital, 11800 East 12 Mile Road, Warren, MI 48093 | 2020-10-05 |
| 1679112676 | Open Heart Communities | Case Management | 31310 Shaw Dr, Warren, MI 48093 | 2019-12-23 |
| 1538715636 | 3 Dove Medical Supplies | Durable Medical Equipment & Medical Supplies | 31201 Chicago Rd S Ste C101, Warren, MI 48093 | 2019-08-14 |
| 1568954600 | Schreiber Cardiology, P.C. | Internal Medicine | 8545 Common Rd Ste 150, Warren, MI 48093 | 2018-06-05 |
| 1730686197 | Lambro Seremetis | Social Worker | 12200 E. 12 Mile Road, Ste. 200, Warren, MI 48093 | 2018-04-11 |
| 1649775826 | Ridge Downs | Behavioral Analyst | 31201 Chicago Rd South, Suite C- 202, Warren, MI 48093 | 2018-03-28 |
| 1144722737 | Jessica Farraj | Occupational Therapist | 11800 E. 12 Mile Road, Warren, MI 48093 | 2018-02-28 |
| 1265930168 | Leah Hanrahan | Registered Nurse | 11700 Amberle Dr., Warren, MI 48093 | 2018-01-25 |
| 1598271553 | Pamela Marie Confer | Occupational Therapist | 11012 13 Mile Rd, Suite 200, Warren, MI 48093 | 2017-12-28 |
| 1831604347 | Kate Jeanne Szczepanski | Behavior Technician | 31200 Chicago Rd S, Warren, MI 48093 | 2017-12-06 |
| Find all providers in zip 48093 | ||||
| Taxonomy Code | 283Q00000X |
| Grouping | Hospitals |
| Classification | Psychiatric Hospital |
| An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. |
| Notes: Source: Expanded from Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588672406 | T & G Corporation Inc | Psychiatric Hospital | 4050 E 12 Mile Rd, Warren, MI 48092-2534 | 2006-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285277814 | Lansing Senior Partners LLC | Psychiatric Hospital | 3512 Coolidge Rd, East Lansing, MI 48823-6376 | 2019-10-27 |
| 1336498013 | Genesys Hillside Behavioral Services | Psychiatric Hospital | 4396 Meadows Ave, Grand Blanc, MI 48439-8689 | 2012-09-10 |
| 1275727653 | Head To Mind Psychiatric Services Inc | Psychiatric Hospital | 19450 Argyle Cres, Detroit, MI 48203-1402 | 2007-08-29 |
| 1629108766 | Circle of Life | Psychiatric Hospital | 24080 Seneca St, Oak Park, MI 48237-3725 | 2007-03-07 |
| 1205973922 | Circle of Life Psychiatric Hospital | Psychiatric Hospital | 403 Village Green Blvd, Apt 106, Ann Arbor, MI 48105-3612 | 2007-01-31 |
| 1053342220 | Havenwyck Hospital Inc | Psychiatric Hospital | 1525 University Dr, Auburn Hills, MI 48326-2673 | 2006-07-06 |
| 1710918362 | Henry Ford Health System | Psychiatric Hospital | 10300 W 8 Mile Rd, Ferndale, MI 48220-2100 | 2006-07-05 |
| 1033108832 | Triangle Industries Inc | Psychiatric Hospital | 15000 Gratiot Ave, Detroit, MI 48205-1973 | 2005-10-14 |
| 1053841650 | Havenwyck Hospital Inc | Psychiatric Hospital | 101 W Townsend Rd, St Johns, MI 48879 | 2017-06-15 |
| 1154771335 | Harpa Lind Jonsdottir | Psychiatric Hospital | 300 68th St Se, Pine Rest Mental Health Services, Grand Rapids, MI 49548-6927 | 2016-06-17 |
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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.