MERCY MEMORIAL HOSPITAL CORPORATION (NPI# 1659558765) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659558765 |
| Entity Type | Organization |
| Organization Name | MERCY MEMORIAL HOSPITAL CORPORATION |
| Practice Address |
718 N Macomb St Monroe MI 48162-7815 |
| Practice Telephone | 7342401440 |
| Practice Fax Number | 7342401550 |
| Mailing Telephone | 7342401440 |
| Mailing Fax Number | 7342401550 |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2008-01-31 |
| Authorized Official Name | KIANOUSH KHAGHNAY (GROUP REP) |
| Authorized Official Telephone | 7342401442 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | MERCY MEMORIAL OB SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VM0101X |
Obstetrics & Gynecology Specialization: Maternal & Fetal Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BLUE CROSS | 0E81076 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659614022 | Mercy Memorial Hospital Corporation | Family Medicine | 650 Steward Road, Monroe, MI 48162 | 2013-04-03 |
| 1386721413 | Mercy Memorial Hospital Corporation | Home Health | 1070 N Monroe St, Monroe, MI 48162 | 2006-11-01 |
| 1437635505 | Mercy Memorial Hospital Corporation | General Acute Care Hospital | 718 N Macomb St, Monroe, MI 48162-7815 | 2018-07-12 |
| 1811426331 | Mercy Memorial Hospital Corporation | Clinical Medical Laboratory | 718 N Macomb St, Monroe, MI 48162-7815 | 2017-06-08 |
| 1376997551 | Mercy Memorial Hospital Corporation | Specialist | 800 Stewart Rd, Monroe, MI 48162-4226 | 2016-04-14 |
| 1861636540 | Mercy Memorial Hospital Corporation | Internal Medicine | 718 N Macomb St, Monroe, MI 48162-7815 | 2009-04-27 |
| 1972781714 | Mercy Memorial Hospital Corporation | Community/Behavioral Health | 700 Stewart Rd, Monroe, MI 48162-5304 | 2008-02-04 |
| 1942487053 | Mercy Memorial Hospital Corporation | Psychiatry & Neurology | 718 N Macomb St, Monroe, MI 48162-7815 | 2008-01-31 |
| 1174700694 | Mercy Memorial Hospital Corporation | Emergency Medicine | 100 Powell Dr, Dundee, MI 48131-8644 | 2008-01-28 |
| 1942354873 | Mercy Memorial Hospital Corporation | Community/Behavioral Health | 700 Stewart Rd, Ste 105, Monroe, MI 48162-5304 | 2007-01-22 |
| Street Address |
718 N MACOMB ST |
| City | MONROE |
| State | MI |
| Zip Code | 48162-7815 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790781300 | Mark D Sherrard | Family Medicine | 718 N Macomb St, Monroe, MI 48162-7815 | 2005-06-28 |
| 1841801222 | Vijaya Lakshmi Lakshmi Thotakura | Physician Assistant | 718 N Macomb St, Monroe, MI 48162-7815 | 2020-08-11 |
| 1952928467 | Edwin David | General Practice | 718 N Macomb St, Monroe, MI 48162-7815 | 2020-06-30 |
| 1255957494 | Nicole Philippon | Nurse Practitioner | 718 N Macomb St, Monroe, MI 48162-7815 | 2020-06-23 |
| 1407471451 | Joseph Hoeksema | Emergency Medicine | 718 N Macomb St, Monroe, MI 48162-7815 | 2020-06-15 |
| 1366067779 | Megan Wolbers | General Practice | 718 N Macomb St, Monroe, MI 48162-7815 | 2020-06-11 |
| 1598380909 | Himat Singh Gill | General Practice | 718 N Macomb St, Monroe, MI 48162-7815 | 2020-06-11 |
| 1659996221 | Nathaniel Lucey | Emergency Medicine | 718 N Macomb St, Monroe, MI 48162-7815 | 2020-06-10 |
| 1497370068 | Krysten Hinton | Emergency Medicine | 718 N Macomb St, Monroe, MI 48162-7815 | 2020-06-10 |
| 1598380123 | Paul Van Truong | Emergency Medicine | 718 N Macomb St, Monroe, MI 48162-7815 | 2020-06-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568016012 | Silke A Goudos | Nurse Practitioner | 730 N Macomb Street #200, Monroe, MI 48162 | 2019-08-01 |
| 1134781412 | Joshua Dwaine Lentz | Family Medicine | Promedica Monroe Regional Hospital, 650 Stewart Road, Monroe, MI 48162 | 2019-07-08 |
| 1740769702 | Carissa Pollock | Behavioral Analyst | 2086 S. Custer Rd., Monroe, MI 48162 | 2018-08-10 |
| 1710488440 | Stacy Michael Lucio | Nurse Practitioner | 901 N Macomb St Ste 109, Monroe, MI 48162 | 2018-02-27 |
| 1407239882 | Lisa Gilbert Peleman | Student in an Organized Health Care Education/Training Program | Promedica Monroe Regional Hospital Family Medicine Res, 650 Stewart Rd, Monroe, MI 48162 | 2015-07-03 |
| 1427430552 | Cheryl Fosgate | Counselor | 4350 N Monroe St, Monroe, MI 48162 | 2015-06-25 |
| 1538551460 | Convenient Mr PC | Dentist | 7500 N. Telegraph Rd., Monroe, MI 48162 | 2015-03-02 |
| 1659614022 | Mercy Memorial Hospital Corporation | Family Medicine | 650 Steward Road, Monroe, MI 48162 | 2013-04-03 |
| 1073872743 | Justin L Chamberlain | Surgery | 730 N Macomb St Ste 329, Monroe, MI 48162 | 2012-05-15 |
| 1639462674 | Toledo Clinic Incorporated | Durable Medical Equipment & Medical Supplies | 800 Stewart Road, Suite B, Monroe, MI 48162 | 2011-05-24 |
| Find all providers in zip 48162 | ||||
| Taxonomy Code | 207VM0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Maternal & Fetal Medicine |
| An obstetrician/gynecologist who cares for, or provides consultation on, patients with complications of pregnancy. This specialist has advanced knowledge of the obstetrical, medical and surgical complications of pregnancy and their effect on both the mother and the fetus. The specialist also possesses expertise in the most current diagnostic and treatment modalities used in the care of patients with complicated pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669854816 | Spectrum Health Primary Care Partners | Obstetrics & Gynecology | 4249 Parkway Place Dr Sw, Grandville, MI 49418-2679 | 2015-06-24 |
| 1588840573 | Silvio Aladjem | Obstetrics & Gynecology | 1655 W State Rd, Hastings, MI 49058-8557 | 2008-01-21 |
| 1659572329 | Erhard Herwig Marz | Obstetrics & Gynecology | 1767 S M 52, Owosso, MI 48867-9201 | 2007-05-30 |
| 1487694949 | Susan Berman | Obstetrics & Gynecology | 4201 St Antoine Ste 4e&f, University Health Center, Detroit, MI 48201 | 2006-06-06 |
| 1164469680 | Bernard Gonik | Obstetrics & Gynecology | Sinai Grace Hospital-atenatal Diagnostic Unit, 6071 W Outer Dr, Detroit, MI 48235 | 2006-06-01 |
| 1285685503 | Sara H Garmel | Obstetrics & Gynecology | 2142 Monroe St Ste 100, Dearborn, MI 48124-3057 | 2006-05-12 |
| 1619926185 | Susan J. Sherman | Obstetrics & Gynecology | 43077 Brookstone Dr, Novi, MI 48377-2714 | 2006-05-10 |
| 1083663983 | Gregory L Goyert | Obstetrics & Gynecology | 3301 W Grand St, 8th Floor, Detroit, MI 48238-2793 | 2006-05-08 |
| 1780658443 | St Joseph Mercy Hospital | Obstetrics & Gynecology | 5301 Huron River Drive, Ypsilanti, MI 48197-1051 | 2006-02-17 |
| 1861470296 | Mark E Redman | Obstetrics & Gynecology | 17400 W 13 Mile Rd, Beverly Hills, MI 48025-5439 | 2006-01-05 |
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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.