ST JOHN HOSPITAL AND MEDICAL CENTER (NPI# 1740312685) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740312685 |
| Entity Type | Organization |
| Organization Name | ST JOHN HOSPITAL AND MEDICAL CENTER |
| Practice Address |
26755 Ballard St Harrison Township MI 48045-2419 |
| Mailing Address |
28000 Dequindre Rd Warren MI 48092-2468 |
| Practice Telephone | 5837530011 |
| Mailing Telephone | 5867530011 |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2010-04-22 |
| 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 |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBSM PIN | 0E01105 | 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 |
| 1346488863 | St John Hospital and Medical Center | Podiatrist | 22101 Moross Rd, Detroit, MI 48236-2148 | 2009-01-22 |
| 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 |
| Street Address |
26755 BALLARD ST |
| City | HARRISON TOWNSHIP |
| State | MI |
| Zip Code | 48045-2419 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043478910 | Ascension St John Hospital | Podiatrist | 26755 Ballard St, Harrison Township, MI 48045-2419 | 2008-05-28 |
| 1245446541 | Beatrice A Erdos | Pharmacist | 26755 Ballard St, Harrison Township, MI 48045-2419 | 2007-05-15 |
| 1558576504 | Mary Ellen Mclain | Pharmacist | 26755 Ballard St, Harrison Township, MI 48045-2419 | 2007-05-13 |
| 1295867133 | St. John North Shores Hospital | Clinic/Center | 26755 Ballard St, Harrison Township, MI 48045-2419 | 2007-03-09 |
| 1598811614 | Jennifer Litzenberg | Specialist/Technologist | 26755 Ballard St, Harrison Township, MI 48045-2419 | 2007-01-25 |
| 1255484382 | Leslie Ellen Mcgill-mayotte | Registered Nurse | 26755 Ballard St, Harrison Township, MI 48045-2419 | 2007-01-20 |
| 1376613638 | St John North Shores Emergency Physicians, P. C. | Emergency Medicine | 26755 Ballard St, Emergency Department, Harrison Township, MI 48045-2419 | 2006-11-08 |
| 1245339290 | Carla Elyse Shock | Nurse Practitioner | 26755 Ballard St, Harrison Township, MI 48045-2419 | 2006-09-22 |
| 1477669224 | Shirley Sayles | Pharmacist | 26755 Ballard St, Harrison Township, MI 48045-2419 | 2006-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447602040 | Integrated Solution LLC | Social Worker | 24791 Parkside St., Apt. 206, Harrison Township, MI 48045 | 2016-07-07 |
| 1598908352 | Andrew Frank Langlois | Pharmacist | 28350 S.river Rd, Harrison Twp, MI 48045 | 2009-04-09 |
| 1629241559 | Brandon Charles Holda | Technician, Other | 43401 N. Jefferson Bldg #825, Selfridge Angb, MI 48045 | 2008-04-11 |
| 1902022601 | Detroit Uscg Phcy | Military/U.S. Coast Guard Pharmacy | 43355 North Jefferson, Uscg Clinic - Bldg 825, Detroit, MI 48045 | 2007-04-18 |
| 1477620755 | Uscg Clinic Sector Detroit | Clinic/Center | 43401 N. Jefferson, Bldg 825, Selfridge Angb, MI 48045 | 2006-11-29 |
| 1568561983 | Ireland Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 410 Mitchell, Selfridge Air Base, MI 48045 | 2006-09-22 |
| 1477661700 | Bridgeview Chiropractic Center | Chiropractor | 28326 S River Rd, Harrison Twp, MI 48045 | 2006-08-28 |
| 1851362586 | St. John Hospital and Medical Center | General Acute Care Hospital | 26755 Ballard Road, Harrison Township, MI 48045 | 2006-01-31 |
| 1013256296 | Mclaren Macomb | Emergency Medicine | 39833 Bridgeview St, Harrison Township, MI 48045 | 2013-02-07 |
| 1265467682 | Venkateswara Rao Malineni | Psychiatry & Neurology | 215 North Ave, St Joseph Specialty Hospital 215, Mt Clemens, MI 48045 | 2006-07-12 |
| Find all providers in zip 48045 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (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. 548. |
| 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 |
| 1245850957 | Black River Anesthesia Staffing LLC | Nurse Anesthetist, Certified Registered | 7245 Baseline Rd, South Haven, MI 49090-9176 | 2020-04-22 |
| 1669008017 | Kalin Elizabeth Wade | Nurse Anesthetist, Certified Registered | 4485 Kenneth Dr Apt C207, Okemos, MI 48864-1900 | 2020-03-18 |
| 1215568340 | Complete Ketamine Inc | Nurse Anesthetist, Certified Registered | 98 Winchester St, Monroe, MI 48161-1957 | 2020-01-28 |
| 1730729740 | Pride Mudzwova | Nurse Anesthetist, Certified Registered | 57693 Dakota Dr, New Hudson, MI 48165-9336 | 2020-01-08 |
| 1982249041 | Leif Elias | Nurse Anesthetist, Certified Registered | 3443 Oak Dr, Ann Arbor, MI 48105-9798 | 2019-11-13 |
| 1619512779 | Yvonne Marie Bridgeford | Nurse Anesthetist, Certified Registered | 2113 Mason Rd, Howell, MI 48843-8903 | 2019-11-13 |
| 1184269243 | Jaclyn Rochefort | Nurse Anesthetist, Certified Registered | 5381 Frovan Pl, Saginaw, MI 48638-5573 | 2019-11-13 |
| 1932744091 | Sean S Vanderwaal | Nurse Anesthetist, Certified Registered | 1420 Perry Rd Apt 1-8, Grand Blanc, MI 48439-1727 | 2019-11-13 |
| 1467093153 | Apollo Medical Group of Traverse City Pllc | Nurse Anesthetist, Certified Registered | 3663 N Country Dr, Traverse City, MI 49684-4587 | 2019-10-03 |
| Find all providers with the same taxonomy | ||||
| City | HARRISON TOWNSHIP |
| Zip Code | 48045 |
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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.