ST. JOHN HOSPITAL AND MEDICAL CENTER (NPI# 1376854661) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376854661 |
| Entity Type | Organization |
| Organization Name | ST. JOHN HOSPITAL AND MEDICAL CENTER |
| Other Organization Name | MEDICAL RESOURCES GROUP NURSE PRACTITIONERS |
| Practice Address |
2800 Livernois Rd Suite 500 Troy MI 48083-1215 |
| Practice Telephone | 2486808000 |
| Practice Fax Number | 2486808031 |
| Mailing Telephone | 2486808000 |
| Mailing Fax Number | 2486808031 |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2016-01-26 |
| Authorized Official Name | JENNIFER JOHNSON (DIRECTOR) |
| Authorized Official Telephone | 2486808206 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| Medical Resources Group Nurse Practitioners | Doing Business As Name - Organization |
| 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 |
| 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 |
| 1386892834 | St. John Hospital and Medical Center | Family Medicine | 21099 Masonic Blvd, Saint Clair Shores, MI 48082-1045 | 2008-09-08 |
| Street Address |
2800 LIVERNOIS RD SUITE 500 |
| City | TROY |
| State | MI |
| Zip Code | 48083-1215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225093776 | Ascension Providence Hospital | Nuclear Medicine | 2800 Livernois Rd, Blgd D Suite 500, Troy, MI 48083-1215 | 2006-04-19 |
| 1851765374 | Ascension Michigan-cmg | Family Medicine | 2800 Livernois Rd, Bldg E Suite 275, Troy, MI 48083-1215 | 2015-11-20 |
| 1598177065 | Seton Health Corporation of Southeastern Michigan | Internal Medicine | 2800 Livernois Rd, Suite 500, Troy, MI 48083-1215 | 2014-06-02 |
| 1720390453 | Ascension Macomb Oakland Hospital | Internal Medicine | 2800 Livernois Rd, Suite 500, Troy, MI 48083-1215 | 2010-07-10 |
| 1457663197 | Ascension St John Hospital | Family Medicine | 2800 Livernois Rd, Suite 500, Troy, MI 48083-1215 | 2010-07-10 |
| 1114133485 | Ascension Medical Group Michigan | Pediatrics | 2800 Livernois Rd, Suite 500, Troy, MI 48083-1215 | 2007-05-15 |
| 1376644922 | Ascension Medical Group Michigan | Family Medicine | 2800 Livernois Rd, Troy, MI 48083-1215 | 2006-09-26 |
| 1942317631 | Ascension Medical Group Michigan | Obstetrics & Gynecology | 2800 Livernois Rd, Suite 500, Troy, MI 48083-1215 | 2006-08-25 |
| 1174537500 | Ascension Medical Group Michigan | Family Medicine | 2800 Livernois Rd, Suite 500, Troy, MI 48083-1215 | 2006-07-28 |
| 1730117805 | Ascension Medical Group Michigan | Family Medicine | 2800 Livernois Rd, Troy, MI 48083-1215 | 2006-06-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417420449 | Thapasvi Muttirevula | Physical Therapist | 2422 Cedar Knoll Dr, Troy, MI 48083 | 2019-01-02 |
| 1114418290 | Ann Katchke | Physical Therapist | 3179 Livernois Rd, Troy, MI 48083 | 2018-05-23 |
| 1518485945 | Risa Rae Mendelson | Counselor | 1059 Owendale Street, Troy, MI 48083 | 2017-09-06 |
| 1497277115 | Gassan Asadi | Pharmacist | 215 E Big Beaver Rd Ste 500, Troy, MI 48083 | 2017-07-14 |
| 1528510328 | Dylan Skye Polasko | Behavioral Analyst | 2221 E 4th St, #101, Troy, MI 48083 | 2016-10-27 |
| 1235683061 | Sadia Ghazi | Technician, Other | 3178 Daley Dr., Troy, MI 48083 | 2016-08-10 |
| 1548664345 | Amber Leigh Ernst | Social Worker | 1225 E. Big Beaver Road, Troy, MI 48083 | 2014-10-22 |
| 1356782411 | Michelle Louise Knoblock | Nurse Anesthetist, Certified Registered | 1560 E Maple Rd Ste 100, Troy, MI 48083 | 2013-07-17 |
| 1437400728 | Oakland Physicians Surgery Center | Clinic/Center | 1560 E. Maple Road, Suite 100, Troy, MI 48083 | 2012-09-26 |
| 1861748238 | Pro Med Substance Abuse Program LLC | Psychologist | 2891 E. Maple Rd. Suite 200, Troy, MI 48083 | 2012-08-03 |
| Find all providers in zip 48083 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356948483 | Dawn Aimee Fisher | Nurse Practitioner | 2187 Hunters Lodge Rd, Troy, VA 22974-4344 | 2020-10-01 |
| 1124657143 | Angela Dalton | Nurse Practitioner | 1001 S Dorset Rd # C, Troy, OH 45373-4750 | 2020-04-02 |
| 1811528029 | Alzea Dorena Rineer | Nurse Practitioner | 15900, Us -6, Troy, PA 16947-1694 | 2020-01-28 |
| 1861052565 | Hannah Grainger | Nurse Practitioner | 44199 Dequindre Rd Ste G10, Troy, MI 48085-1128 | 2019-06-17 |
| 1649736729 | Marilyn Alysse Chengo | Nurse Practitioner | 1200 Kirts Blvd Ste 200, Troy, MI 48084-4899 | 2019-02-14 |
| 1144770454 | Sarah Neal | Nurse Practitioner | 3130 N Country Rd 25 A, Troy, OH 45373-1337 | 2016-10-11 |
| 1700334125 | Diane Byrd Campbell | Nurse Practitioner | 102 Regents Dr, Troy, MI 48084-5421 | 2016-09-14 |
| 1982151148 | Amanda Falldorf | Nurse Practitioner | 1843 W Main St, Troy, OH 45373 | 2016-09-06 |
| 1649614009 | Latishia Renee-denise Berry | Nurse Practitioner | 880 W Long Lake Rd, Troy, MI 48098-4504 | 2013-04-29 |
| 1780901439 | Rosanna Marie Marrocco | Nurse Practitioner | 1777 Axtell Dr Ste 202, Troy, MI 48084-4435 | 2010-04-21 |
| Find all providers in TROY | ||||
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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.