ST JOHN MACOMB OAKLAND HOSPITAL (NPI# 1427215235) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427215235 |
| Entity Type | Organization |
| Organization Name | ST JOHN MACOMB OAKLAND HOSPITAL |
| Practice Address |
11800 E 12 Mile Rd Warren MI 48093-3472 |
| Mailing Address |
28000 Dequindre Rd Warren MI 48092-2468 |
| Practice Telephone | 5865735000 |
| Mailing Telephone | 5867530275 |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2008-05-20 |
| 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 | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BLUE CROSS | 300E011130 | 01 |
| 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 |
| 1770750309 | St John Macomb Oakland Hospital | General Acute Care Hospital | 7733 E Jefferson Ave, Detroit, MI 48214-3707 | 2008-05-13 |
| 1811102742 | St John Macomb Oakland Hospital | Pathology | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2007-05-14 |
| Street Address |
11800 E 12 MILE RD |
| City | WARREN |
| State | MI |
| Zip Code | 48093-3472 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740280940 | Manisha Kaur Bajwa | Pharmacist | 11800 E 12 Mile Rd, Pharmacy Department, Warren, MI 48093-3472 | 2005-07-28 |
| 1679181986 | Roxana Lionte | Nurse Practitioner | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2020-07-22 |
| 1649893355 | Patrick Yang | Student in an Organized Health Care Education/Training Program | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2020-05-28 |
| 1831711936 | Elisheva Ellenberg | Nurse Practitioner | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2020-05-12 |
| 1427686716 | Pavan Kumar Ravipati | Student in an Organized Health Care Education/Training Program | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2020-03-31 |
| 1962038885 | Natasha Mehta | Student in an Organized Health Care Education/Training Program | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2020-03-23 |
| 1194350645 | Katherine Sara Streidl | Nurse Anesthetist, Certified Registered | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2020-03-05 |
| 1891326898 | Clara Poparad-stezar | Student in an Organized Health Care Education/Training Program | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2020-01-28 |
| 1023653797 | Lauren Ashley Shailor | Nurse Practitioner | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2019-11-16 |
| 1700428984 | Olivia Lynn Hedman | Dietitian, Registered | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2019-10-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023615986 | Toleka Regina Taylor | Nurse Anesthetist, Certified Registered | St. John Macomb Hospital, 11800 East 12 Mile Road, Warren, MI 48093 | 2020-10-05 |
| 1679112676 | Open Heart Communities | Case Management | 31310 Shaw Dr, Warren, MI 48093 | 2019-12-23 |
| 1538715636 | 3 Dove Medical Supplies | Durable Medical Equipment & Medical Supplies | 31201 Chicago Rd S Ste C101, Warren, MI 48093 | 2019-08-14 |
| 1568954600 | Schreiber Cardiology, P.C. | Internal Medicine | 8545 Common Rd Ste 150, Warren, MI 48093 | 2018-06-05 |
| 1730686197 | Lambro Seremetis | Social Worker | 12200 E. 12 Mile Road, Ste. 200, Warren, MI 48093 | 2018-04-11 |
| 1649775826 | Ridge Downs | Behavioral Analyst | 31201 Chicago Rd South, Suite C- 202, Warren, MI 48093 | 2018-03-28 |
| 1144722737 | Jessica Farraj | Occupational Therapist | 11800 E. 12 Mile Road, Warren, MI 48093 | 2018-02-28 |
| 1265930168 | Leah Hanrahan | Registered Nurse | 11700 Amberle Dr., Warren, MI 48093 | 2018-01-25 |
| 1598271553 | Pamela Marie Confer | Occupational Therapist | 11012 13 Mile Rd, Suite 200, Warren, MI 48093 | 2017-12-28 |
| 1831604347 | Kate Jeanne Szczepanski | Behavior Technician | 31200 Chicago Rd S, Warren, MI 48093 | 2017-12-06 |
| Find all providers in zip 48093 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497959183 | Bi-county Physicians Practices | Radiology | 13355 East 10 Mile Road, Warren, MI 48089-2048 | 2007-06-14 |
| 1013070135 | Mcnichols Xray Clinic PC | Radiology | 21230 Dequindre Road, Southeast Michigan Surgical Hospital, Warren, MI 48091 | 2006-12-19 |
| 1598786451 | Walter H Kuhnen | Radiology | 2 12 Crescent Park, Warren, PA 16365 | 2006-07-23 |
| 1457370330 | Neha Kothari | Radiology | 9 Cotswold Ln, Warren, NJ 07059-6900 | 2006-07-19 |
| 1871518449 | Radiology Specialties PC | Radiology | 13355 East Ten Mile Rd, Warren, MI 48089-1240 | 2006-07-13 |
| 1477578144 | Diagnostic Radiology Consultants PC | Radiology | 11800 E Twelve Mile Road, St John Macomb Hospital, Warren, MI 48093 | 2006-07-13 |
| 1144263153 | Franklin D Wald | Radiology | 9 Nottingham Way, Warren, NJ 07059-6754 | 2006-06-14 |
| 1881651909 | Robert Palmer Stecher | Radiology | 2900 Sandpiper Trl Se, Warren, OH 44484-5706 | 2006-05-01 |
| 1972586717 | Great Lakes Mri of Michigan LLC | Radiology | 27301 Schoenherr Rd, Suite 100, Warren, MI 48088-6649 | 2005-11-25 |
| 1154319259 | Medical Imaging Network Inc | Radiology | 5500 E Market St, Warren, OH 44484-2214 | 2005-10-12 |
| Find all providers in WARREN | ||||
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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.