PROVIDENCE HOSPITAL (NPI# 1548486681) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548486681 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HOSPITAL |
| Practice Address |
10508 Keane Dr Grass Lake MI 49240-8803 |
| Mailing Address |
16001 West 9 Mile Road Department of General Surgery Southfield MI 48075 |
| Practice Telephone | 5175224451 |
| Mailing Telephone | 2488493073 |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. VIJAY MITTAL (PROGRAM DIRECTOR) |
| Authorized Official Telephone | 2488493073 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | L952723 | MI | Hospitals |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134584667 | Providence Hospital | Clinic/Center | 3413 Olive Branch Dr, Silver Spring, MD 20904-4973 | 2015-12-29 |
| 1881891372 | Providence Hospital | Chronic Disease Hospital | 16400 N Park Dr Apt 1008, Southfield, MI 48075-4728 | 2007-06-28 |
| 1932277050 | Providence Hospital | Rehabilitation Hospital | 6351 Woodside Dr, Theodore, AL 36582-6061 | 2006-11-30 |
| 1861057416 | Providence Hospital | Clinic/Center | 1150 Varnum St Ne, Washington, DC 20017-2180 | 2019-05-08 |
| 1861954638 | Providence Hospital | Emergency Medicine | 1150 Varnum St Ne, Washington, DC 20017-2180 | 2019-04-02 |
| 1710362496 | Providence Hospital | General Acute Care Hospital | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 | 2015-07-23 |
| 1871922971 | Providence Hospital | Hospitalist | 6801 Airport Blvd, Hospitalist Dept., Mobile, AL 36608-3709 | 2013-11-08 |
| 1992133912 | Providence Hospital | Anesthesiology | 6801 Airport Blvd, Anesthesia Dept., Mobile, AL 36608-3709 | 2013-10-30 |
| 1659707149 | Providence Hospital | General Acute Care Hospital | 1150 Varnum St Ne, Washington, DC 20017-2104 | 2013-09-17 |
| 1649616384 | Providence Hospital | General Acute Care Hospital | 1150 Varnum St Ne, Washington, DC 20017-2104 | 2013-05-21 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PROVIDENCE HOSPITAL | 914 S Scheuber Rd, Centralia, WA 98531-9027 |
| System for Award Management (SAM) Entities | PROVIDENCE HOSPITAL AND MEDICAL CENTERS | 16001 W 9 Mile Rd, Southfield, MI 48075-4818 |
| Iowa Business Entities | PROVIDENCE HOSPITALITY PARTNERS LLC | 709 Clarkson St, Denver, CO 80218 |
| Colorado Business Entities | PROVIDENCE HOSPITALITY PARTNERS LLC | 1888 N Sherman St, Suite 610, Denver, CO 80203 |
| New York State Corporations | PROVIDENCE HOSPITALITY PARTNERS LLC | 1888 N Sherman St, Suite 610, Denver, Co 80203 |
| Street Address |
10508 KEANE DR |
| City | GRASS LAKE |
| State | MI |
| Zip Code | 49240-8803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790306991 | Grass Lake Surgery Center LLC | Clinic/Center | 3800 Centennial Blvd, Grass Lake, MI 49240 | 2020-04-29 |
| 1952969172 | Indispensable Health | Pharmacy | 114 E. Michigan Ave, Suite 2, Grass Lake, MI 49240 | 2019-06-03 |
| 1205169851 | David Oneill Foley | Reflexologist | 1165 Rowena Ave, Grass Lake, MI 49240 | 2009-09-15 |
| 1336240225 | Kathleen Anzicek | Family Medicine | 12337 E Michigan Ave, Grass Lake, MI 49240-0246 | 2006-09-26 |
| 1174637995 | Mark E Leventer | Family Medicine | 12337 E Michigan Ave, Grass Lake, MI 49240-0246 | 2006-08-18 |
| 1821299959 | Betsabe Molleda | Massage Therapist | 11231 Huckleberry Ln, Grass Lake, MI 49240-8957 | 2007-05-29 |
| 1639789522 | Ian Shepstone | Chiropractor | 139 W Michigan Ave, Grass Lake, MI 49240-9188 | 2020-08-05 |
| 1477746600 | Patrick Raymond Eckes | Chiropractor | 125 W Michigan Ave, Grass Lake, MI 49240-9188 | 2007-08-21 |
| 1629233150 | Grass Lake Chiropractic Center, Pllc | Chiropractor | 125 W Michigan Ave, Grass Lake, MI 49240-9188 | 2008-07-24 |
| 1447413380 | Daniel Nelson Mikel | Chiropractor | 125 W Michigan Ave, Grass Lake, MI 49240-9188 | 2008-07-09 |
| Find all providers in zip 49240 | ||||
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740899194 | Ascension Michigan Employer Solutions LLC | General Acute Care Hospital | 5555 Conner St Ste 2818, Detroit, MI 48213-3448 | 2020-07-30 |
| 1295246106 | Henry Ford Health Sytems | General Acute Care Hospital | 18800 Hubbard Dr, Dearborn, MI 48126-4305 | 2017-10-18 |
| 1972043081 | Melissa Kovaleski | General Acute Care Hospital | 1029 Chestnut Ln, South Lyon, MI 48178-1896 | 2017-03-08 |
| 1699125922 | Sarah Finlay | General Acute Care Hospital | 5333 Mcauley Dr Ste 40001, Ypsilanti, MI 48197-1014 | 2016-06-17 |
| 1528412517 | Bess Marie Connors | General Acute Care Hospital | 1506 Pontiac Trl, Ann Arbor, MI 48105-1719 | 2016-04-16 |
| 1093198624 | The Memorial Hospital | General Acute Care Hospital | 826 W King St # 1-117, Owosso, MI 48867-2120 | 2015-07-01 |
| 1326428285 | Ipc Hospitalist Company | General Acute Care Hospital | 1628 Huntwood Park Ct, West Bloomfield, MI 48324-3998 | 2015-06-05 |
| 1689088304 | Florida Hospital | General Acute Care Hospital | 7922 Barrie, Dearborn, MI 48126 | 2014-06-20 |
| 1720491954 | University of Michigan | General Acute Care Hospital | 1515 E. Hospital Drive, Towsley Center, 1218, Spc 5222, Ann Arbor, MI 48109-5222 | 2014-06-05 |
| 1366866956 | Bronson Methodist Hospital | General Acute Care Hospital | 601 John St Ste M-425, Kalamazoo, MI 49007-5354 | 2014-02-18 |
| Find all providers with the same taxonomy | ||||
| City | GRASS LAKE |
| Zip Code | 49240 |
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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.