ST JOHN HOSPITAL AND MEDICAL CENTER (NPI# 1346488863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346488863 |
| 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 | 2009-01-22 |
| Last Update Date | 2009-01-22 |
| Authorized Official Name | SUSAN L FIELD (DIRECTOR) |
| Authorized Official Telephone | 5867530011 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE CROSS | 4855056200 | 01 |
| 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 |
| 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 |
| 1609035229 | 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 | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992155576 | Chinenye Ezike | Podiatrist | 22201 Moross Rd Ste 250, Detroit, MI 48236-2175 | 2016-06-15 |
| 1700048931 | Melissa Laura Allen | Podiatrist | 3430 E Jefferson Ave, 523, Detroit, MI 48207-4233 | 2008-06-29 |
| 1942491857 | Michigan Foot Surgeons, P.C. | Podiatrist | 12720 W 7 Mile Rd, Detroit, MI 48235-1301 | 2007-08-06 |
| 1649329590 | Stuart E Kirschenbaum | Podiatrist | 8319 Grand River Ave, Detroit, MI 48204-2231 | 2007-01-09 |
| 1639255946 | Stuart Edward Kirschenbaum | Podiatrist | 3031 W Grand Blvd Ste 423, Detroit, MI 48202-3141 | 2006-10-29 |
| 1679667620 | Cohen Podiatry PC | Podiatrist | 7633 E Jefferson, Suite 250, Detroit, MI 48214 | 2006-10-03 |
| 1134212889 | Herbert Bircoll | Podiatrist | 7633 E. Jefferson, Suite 250, Detroit, MI 48214 | 2006-10-02 |
| 1801905518 | Philip Edward Holmes | Podiatrist | 4646 John R. St, John Dingell Va Medical Center, Dept. of Surgery, Detroit, MI 48201 | 2006-08-29 |
| 1487678686 | Christopher Michael Fallu | Podiatrist | 6795 W Vernor Hwy, Detroit, MI 48209-1551 | 2006-07-27 |
| 1457385841 | Larry Weiss Dpm PC | Podiatrist | 17421 Greenfield, Detroit, MI 48235 | 2006-07-10 |
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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.