ST JOHN HOSPITAL CORPORATION (NPI# 1720111701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720111701 |
| Entity Type | Organization |
| Organization Name | ST JOHN HOSPITAL CORPORATION |
| Other Organization Name | ST JOHN REGISTERED DIETICIAN GROUP |
| Practice Address |
22101 Moross Rd Detroit MI 48236-2148 |
| Mailing Address |
43800 Garfield Rd 200 Clinton Township MI 48038-1136 |
| Practice Telephone | 5862284635 |
| Practice Fax Number | 5862284520 |
| Mailing Telephone | 5862284635 |
| Mailing Fax Number | 5862284520 |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2007-10-12 |
| Authorized Official Name | SANDRA ELLEN WHITMAN (DIRECTOR) |
| Authorized Official Telephone | 5862266823 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | Dietary & Nutritional Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBSM GROUP | OQ262160 | 01 |
| Other Name | Type Code |
|---|---|
| St John Registered Dietician group | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811068760 | St John Hospital Corporation | Physician Assistant | 22101 Moross Rd, Detroit, MI 48236-2148 | 2006-11-13 |
| 1225136906 | St John Hospital Corporation | Ophthalmology | 22101 Moross Rd, Detroit, MI 48236-2148 | 2006-09-20 |
| 1598713414 | St John Hospital Corporation | Surgery | 22101 Moross Rd, Detroit, MI 48236-2148 | 2006-05-04 |
| 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 | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871138636 | Nancy Park | Dietitian, Registered | 1 Ford Pl # 5c, Detroit, MI 48202-3450 | 2019-11-15 |
| 1215581137 | Alyson Mcadams | Dietitian, Registered | 1000 Van Dyke St Apt 203, Detroit, MI 48214-2487 | 2019-07-29 |
| 1396288288 | Dawn Vergin | Dietitian, Registered | 22151 Moross Rd Ste 135, Detroit, MI 48236-2165 | 2016-11-23 |
| 1902286305 | Anjail Askew-ansari | Dietitian, Registered | 19136 Mendota St, Detroit, MI 48221-3216 | 2015-06-02 |
| 1356684815 | Hayward S Penny | Dietitian, Registered | 58 Parsons St, Detroit, MI 48201 | 2013-04-03 |
| 1881975506 | Julie L Fromm | Dietitian, Registered | 5254 Anthony Wayne Dr, Detroit, MI 48202-3924 | 2011-09-08 |
| 1295967834 | Kimberly Patrice Jones | Dietitian, Registered | 18641 Margareta St, Detroit, MI 48219-2930 | 2009-08-16 |
| 1457503690 | Jeanette Roger | Dietitian, Registered | 1151 Taylor St Dept Of, Nutrition Department - 2c, Detroit, MI 48202-1732 | 2008-10-21 |
| 1770741795 | Suzanne Scherer Burns | Dietitian, Registered | 15801 W Mcnichols Rd, Detroit, MI 48235-3543 | 2008-05-27 |
| 1437279627 | Pamela Kay Milan | Dietitian, Registered | 1 Ford Pl # 3a, Detroit, MI 48202-3450 | 2007-03-30 |
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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.