ST JOHN MACOMB OAKLAND HOSPITAL (NPI# 1770750309) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770750309 |
| Entity Type | Organization |
| Organization Name | ST JOHN MACOMB OAKLAND HOSPITAL |
| Other Organization Name | ST JOHN MACOMB OAKLAND HOSPITAL - ST JOHN DETROIT RIVERVIEW CENTER |
| Practice Address |
7733 E Jefferson Ave Detroit MI 48214-3707 |
| Mailing Address |
28000 Dequindre Rd Warren MI 48092-2468 |
| Practice Telephone | 3134994000 |
| Mailing Telephone | 5867530275 |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2008-06-17 |
| Authorized Official Name | RANDOLPH KUMMLER (VP FINANCE) |
| Authorized Official Telephone | 5865735910 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | 282N00000X | MI | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE CROSS PIN | 00048 | 01 |
| Other Name | Type Code |
|---|---|
| St John Macomb Oakland Hospital - St John Detroit Riverview Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578891966 | St John Macomb Oakland Hospital | Audiologist | 11800 E 12 Mile Rd, Suite 1829, Warren, MI 48093-3472 | 2009-11-24 |
| 1013174655 | St John Macomb Oakland Hospital | Pathology | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2008-05-21 |
| 1033376538 | St John Macomb Oakland Hospital | Family Medicine | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2008-05-21 |
| 1326205964 | St John Macomb Oakland Hospital | Emergency Medicine | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2008-05-21 |
| 1811154628 | St John Macomb Oakland Hospital | Pediatrics | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2008-05-20 |
| 1427215235 | St John Macomb Oakland Hospital | Radiology | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2008-05-20 |
| 1811102742 | St John Macomb Oakland Hospital | Pathology | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2007-05-14 |
| Street Address |
7733 E JEFFERSON AVE |
| City | DETROIT |
| State | MI |
| Zip Code | 48214-3707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881681955 | Patricia Barszenski | Nurse Practitioner | 7733 E Jefferson Ave, 1350, Detroit, MI 48214-3707 | 2005-10-04 |
| 1790030690 | Ccla9, LLC | Skilled Nursing Facility | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2012-07-17 |
| 1295018745 | Ccla 9 LLC | Skilled Nursing Facility | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2011-09-21 |
| 1629216007 | Lakshmi Subba Nellutla | Family Medicine | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2009-01-23 |
| 1922257401 | Medical Resource Group | Clinic/Center | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2008-09-09 |
| 1013174655 | St John Macomb Oakland Hospital | Pathology | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2008-05-21 |
| 1033376538 | St John Macomb Oakland Hospital | Family Medicine | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2008-05-21 |
| 1326205964 | St John Macomb Oakland Hospital | Emergency Medicine | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2008-05-21 |
| 1245406875 | Dr. Kerry L. Kole PC | Surgery | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2008-05-04 |
| 1871783530 | Medical Resource Group | Emergency Medicine | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2007-07-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376042325 | Tamara Wesley | Registered Nurse | 9000 E. Jefferson Apt 28-14, Detroit, MI 48214 | 2018-02-06 |
| 1720534381 | Birth Beautiful Detroit | Clinic/Center | 1086 Baldwin, Detroit, MI 48214 | 2016-09-01 |
| 1225402886 | Steven Doyle Whatley I | Counselor | 1423 Field Ave., Adult Well Being Services, Detroit, MI 48214 | 2015-11-19 |
| 1255587945 | Andrew Avery | Internal Medicine | 7733 East Jefferson Ave, Detroit, MI 48214 | 2008-08-13 |
| 1639330210 | Nicole Lashawn Greene | Specialist | 4533 St Clair St, Detroit, MI 48214 | 2008-06-17 |
| 1629299433 | Alan R Faber Jr. | Dentist | 8191 E Jefferson Ave, Detroit, MI 48214 | 2007-05-01 |
| 1518188598 | Mary F Bridges | Psychiatry & Neurology | 8120 East Jefferson #3l, Detroit, MI 48214 | 2007-05-01 |
| 1053439737 | Geraldine Etella Davis | Counselor | 3840 Fairview St., Detroit, MI 48214 | 2007-03-27 |
| 1639203482 | Detroit-macomb Hospital Corporation | Advanced Practice Midwife | 7815 E. Jefferson, Detroit, MI 48214 | 2007-03-15 |
| 1033275441 | Anesha Amor Rouse | Physical Therapy Assistant | 7633 E. Jefferson Ave, Suite 170, Detroit, MI 48214 | 2006-12-29 |
| Find all providers in zip 48214 | ||||
| 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 |
| 1043551146 | Detroit Medical Center | General Acute Care Hospital | 3990 John R Rd, Detroit, MI 48201 | 2013-03-14 |
| 1346511151 | Sara Goldgraben | General Acute Care Hospital | 540 E. Canfield, Department of Radiation Oncology, Detroit, MI 48201 | 2012-01-25 |
| 1174837686 | Detroit Medical Center | General Acute Care Hospital | 4201 St. Antoine- 6g Uhc, 6g Uhc, Detroit, MI 48201 | 2010-07-27 |
| 1922239920 | Wayne State University/detroit Medical Center | General Acute Care Hospital | 4201 Saint Antoine St # 2e, Detroit, MI 48201-2153 | 2009-08-07 |
| 1710134010 | Tetsuhiro Higashida | General Acute Care Hospital | 4201 St. Antoine Suite 6e, Detroit, MI 48201 | 2008-08-19 |
| 1487792818 | Detroit Hope Hospital | General Acute Care Hospital | 801 Virgina Park, Detroit, MI 48202 | 2007-02-01 |
| 1134266687 | Detroit Hope Hospital | General Acute Care Hospital | 801 Virginia Park, Detroit, MI 48202 | 2007-01-31 |
| 1669400305 | Ltac Hospital Detroit, LLC | General Acute Care Hospital | 801 Virginia Park St, Third Floor, Detroit, MI 48202-1925 | 2006-06-29 |
| 1043755788 | Barbara Ann Karmanos Cancer Center | General Acute Care Hospital | 4100 John R St, Detroit, MI 48201-2013 | 2017-01-05 |
| Find all providers in DETROIT | ||||
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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.