ST. JOHN HOSPITAL AND MEDICAL CENTER (NPI# 1750413472) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750413472 |
| Entity Type | Organization |
| Organization Name | ST. JOHN HOSPITAL AND MEDICAL CENTER |
| Practice Address |
22101 Moross Rd Detroit MI 48236-2148 |
| Mailing Address |
28000 Dequindre Rd Warren MI 48092-2468 |
| Practice Telephone | 5867530011 |
| Mailing Telephone | 5867530011 |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2008-06-25 |
| Authorized Official Name | MR. CHRISTOPHER J PALAZZOLO (V.P. - FINANCE) |
| Authorized Official Telephone | 3133433558 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207K00000X | Allergy & Immunology | Allopathic & Osteopathic Physicians | ||
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBSM PIN | 0Q24565 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851362586 | St. John Hospital and Medical Center | General Acute Care Hospital | 26755 Ballard Road, Harrison Township, MI 48045 | 2006-01-31 |
| 1801866942 | St. John Hospital and Medical Center | Rehabilitation Unit | 26755 Ballard St, Harrison Twp, MI 48045-2419 | 2006-01-23 |
| 1285902627 | St. John Hospital and Medical Center | Audiologist | 21000 E 12 Mile Rd, Suite 111, Saint Clair Shores, MI 48081-1116 | 2011-12-13 |
| 1437439502 | St. John Hospital and Medical Center | General Acute Care Hospital | 22151 Moross Rd, Pb I Suite 332, Detroit, MI 48236-2167 | 2011-08-22 |
| 1679881510 | St. John Hospital and Medical Center | Internal Medicine | 19901 E 10 Mile Rd, Saint Clair Shores, MI 48080-1069 | 2010-09-14 |
| 1376854661 | St. John Hospital and Medical Center | Nurse Practitioner | 2800 Livernois Rd, Suite 500, Troy, MI 48083-1215 | 2010-07-01 |
| 1750517678 | St. John Hospital and Medical Center | General Acute Care Hospital | 22101 Moross Rd, Detroit, MI 48236-2148 | 2009-06-05 |
| 1053550996 | St. John Hospital and Medical Center | Clinic/Center | 22201 Moross Rd, Professional Building Two, Suite 50, Detroit, MI 48236-2169 | 2009-02-17 |
| 1346487550 | St. John Hospital and Medical Center | Audiologist-Hearing Aid Fitter | 22101 Moross Rd, Detroit, MI 48236-2148 | 2009-01-09 |
| 1982841193 | St. John Hospital and Medical Center | Audiologist-Hearing Aid Fitter | 22101 Moross Rd, Detroit, MI 48236-2148 | 2009-01-09 |
| 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 | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952909558 | Quilted Rose Clinical Services, Pllc | Clinic/Center | 269 Walker St Ste 256, Detroit, MI 48207-4258 | 2020-10-15 |
| 1851920581 | Emotional Wellness Group LLC | Clinic/Center | 11956 E Outer Dr, Detroit, MI 48224-2630 | 2020-04-04 |
| 1245897503 | Healthy Choice Community Centered Counseling LLC | Clinic/Center | 19300 Greenfield Rd Ste B, Detroit, MI 48235-2003 | 2019-05-22 |
| 1891245775 | Platinum Psychological Services | Clinic/Center | 4777 E Outer Dr Ste 1154, Detroit, MI 48234-3241 | 2016-10-04 |
| 1750837324 | A Plus Care Transportation LLC | Clinic/Center | 14586 Wisconsin, Detroit, MI 48238 | 2016-09-01 |
| 1093157802 | Medical Massage Clinic of Mi., LLC | Clinic/Center | 17151 Wyoming St, Detroit, MI 48221-2451 | 2013-07-22 |
| 1033461728 | Caring Hands Medical Clinical, P.C. | Clinic/Center | 14219 W. Mc Nichols Road, Detroit, MI 48235 | 2012-10-05 |
| 1558619510 | St John Providence Eastwood Clinic | Clinic/Center | 4777 E Outer Dr Ste 1105, Detroit, MI 48234-3241 | 2012-08-23 |
| 1497997068 | Med Care Clinic LLC | Clinic/Center | 16315 Grand River Ave, Detroit, MI 48227-1825 | 2009-03-29 |
| 1841448446 | Theramatrix, Inc. | Clinic/Center | 18601 Mack Avenue #3, Detroit, MI 48236-3250 | 2008-09-08 |
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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.