ST JOHN HOSPITAL AND MEDICAL CENTER (NPI# 1669557922) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669557922 |
| Entity Type | Organization |
| Organization Name | ST JOHN HOSPITAL AND MEDICAL CENTER |
| Practice Address |
22101 Moross Rd Detroit MI 48236-2148 |
| Mailing Address |
35597 Brooke Ct New Baltimore MI 48047-1137 |
| Practice Telephone | 3133434766 |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | SUSAN MACKENZIE (CRNA) |
| Authorized Official Telephone | 5867253106 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
4704125071 | MI | Hospitals |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801198387 | St John Hospital and Medical Center | Clinic/Center | 17700 23 Mile Rd, Ste 200, Macomb, MI 48044-1154 | 2010-12-03 |
| 1760708945 | St John Hospital and Medical Center | Audiologist | 28000 Dequindre Rd, Warren, MI 48092-2468 | 2010-04-14 |
| 1164655585 | St John Hospital and Medical Center | Internal Medicine | 19229 Mack Ave, 24, Grosse Pointe Woods, MI 48236-2858 | 2009-09-02 |
| 1144460676 | St John Hospital and Medical Center | Anesthesiologist Assistant | 22101 Moross Rd, Detroit, MI 48236-2148 | 2009-02-24 |
| 1831338581 | St John Hospital and Medical Center | Dermatology | 22101 Moross Rd, Detroit, MI 48236-2148 | 2009-02-19 |
| 1346488863 | St John Hospital and Medical Center | Podiatrist | 22101 Moross Rd, Detroit, MI 48236-2148 | 2009-01-22 |
| 1891933313 | St John Hospital and Medical Center | Surgery | 22101 Moross Rd, Detroit, MI 48236-2148 | 2009-01-22 |
| 1750546446 | St John Hospital and Medical Center | Radiologic Technologist | 20225 E 9 Mile Rd, Saint Clair Shores, MI 48080-1775 | 2008-07-23 |
| 1740445337 | St John Hospital and Medical Center | Radiology | 46591 Romeo Plank Rd, Suite 137, Macomb, MI 48044-5742 | 2008-07-23 |
| 1083873525 | St John Hospital and Medical Center | Internal Medicine | 22101 Moross Rd, Detroit, MI 48236-2148 | 2008-06-09 |
| Street Address |
22101 MOROSS RD |
| City | DETROIT |
| State | MI |
| Zip Code | 48236-2148 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083609887 | Anne M Schneider | Obstetrics & Gynecology | 22101 Moross Rd, 313, Detroit, MI 48236-2148 | 2005-09-19 |
| 1346848827 | Tanya L Locke | Nurse Practitioner | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-10-15 |
| 1588261556 | Ryan Guthrie | Student in an Organized Health Care Education/Training Program | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-10-02 |
| 1578160743 | Lauren Kudirka | Speech-Language Pathologist | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-10-01 |
| 1952918740 | Lisa Colombo | Nurse Practitioner | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-09-26 |
| 1124635917 | Gjergj George Juncaj | Nurse Practitioner | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-09-26 |
| 1194337881 | Lori Holaly | Nurse Practitioner | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-08-23 |
| 1548870066 | Tamara Siblini | Student in an Organized Health Care Education/Training Program | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-08-10 |
| 1104436583 | David Mark Thomas | Student in an Organized Health Care Education/Training Program | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-07-31 |
| 1780293969 | Alexander Swend Mortensen | Student in an Organized Health Care Education/Training Program | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-07-23 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 48236 | ||||
| Taxonomy Code | 282NC0060X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Critical Access |
| Definition to come. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275695850 | John Dingell Medical Center | General Acute Care Hospital | 14153 Warwick St, Detroit, MI 48223-2950 | 2006-12-14 |
| 1417499419 | Tami Lenoir | General Acute Care Hospital | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2016-11-08 |
| 1457609414 | Henry Ford Health System | General Acute Care Hospital | 2799 W Grand Blvd, Clara Ford Pavilion Room 126, Detroit, MI 48202-2608 | 2012-08-23 |
| 1609155951 | Detroit Medical Center, Wayne State University, Detroit, Mi | General Acute Care Hospital | 4201 Saint Antoine St, Detroit, MI 48201-2153 | 2011-08-04 |
| 1730211483 | Henry Ford Health System | General Acute Care Hospital | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2007-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982154365 | Detroit Medical Center | General Acute Care Hospital | 4713 Pond Run, Canton, MI 48188-2196 | 2016-10-10 |
| 1598147803 | St Joseph Mercy Oakland | General Acute Care Hospital | 874 Golf Dr Apt 101, Pontiac, MI 48341-2394 | 2015-06-23 |
| 1821415811 | Harbor Beach Community Hospital Inc | General Acute Care Hospital | 204 S Huron Ave, Harbor Beach, MI 48441 | 2014-03-27 |
| 1346590882 | Aspirus Ontonagon Hospital, Inc | General Acute Care Hospital | 601 S Seventh St, Ontonagon, MI 49953-1448 | 2012-09-12 |
| 1831454222 | Botsford Hospital | General Acute Care Hospital | 28050 Grand River Ave., Farmington Hills, MI 48336-5919 | 2012-07-11 |
| 1255611497 | Henryford Health System | General Acute Care Hospital | 34824 Birchgrove Dr, H, Sterling Heights, MI 48312-4744 | 2011-08-19 |
| 1992919336 | Francine Greenfield D.d.s., F.a.g.d.corp. | General Acute Care Hospital | 800 W Long Lake Rd, Suite #145, Bloomfield Hills, MI 48302-2056 | 2007-05-09 |
| 1770615668 | Pontiac Osteopathic Hospital | General Acute Care Hospital | 50 N Perry St., Pontiac, MI 48342-2253 | 2007-03-09 |
| 1497820526 | Emergency Care Specialists PC | General Acute Care Hospital | 4100 Embassy Dr Se Ste 201, Grand Rapids, MI 49546-2416 | 2006-11-22 |
| 1417035536 | Munising Memorial Hospital Association | General Acute Care Hospital | 1500 Sand Point Rd, Munising, MI 49862-1406 | 2006-11-02 |
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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.