ST JOHN MACOMB OAKLAND HOSPITAL (NPI# 1811154628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811154628 |
| 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 |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2008-10-16 |
| 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 |
|---|---|---|---|---|---|
| N | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
Allopathic & Osteopathic Physicians | ||
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE CROSS | 0E061220 | 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 |
| 1427215235 | St John Macomb Oakland Hospital | Radiology | 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 | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275853897 | Mae Faye De La Calzada-jeanlouie | Emergency Medicine | 16 Foxglove Dr, Warren, NJ 07059-5000 | 2010-06-05 |
| 1528074416 | Bradley Frank Gutierrez | Emergency Medicine | 11800 E 12 Mile Road, St John Macomb Hospital Dept of Emergency Medicine, Warren, MI 48093 | 2006-07-31 |
| 1437103371 | Markham Emergency Physicians LLC | Emergency Medicine | 404 S Bradley St, Warren, AR 71671-3459 | 2006-05-22 |
| 1659358588 | Pedro A Ballester | Emergency Medicine | 1405 E Market St, Warren, OH 44483-6609 | 2005-12-30 |
| 1285619239 | Zachary F Veres | Emergency Medicine | 4681 Mahoning Ave Nw, Warren, OH 44483-1418 | 2005-12-13 |
| 1366427312 | Melissa S Knarr | Emergency Medicine | 667 Eastland Avenue Se, Warren, OH 44484 | 2005-12-13 |
| 1508850611 | Ernest Depasquale | Emergency Medicine | 1350 E Market St, Warren, OH 44483-6608 | 2005-09-02 |
| 1124501861 | Steward Emergency Physicians Ohio Inc | Emergency Medicine | 1350 E Market St, Warren, OH 44483-6608 | 2018-09-10 |
| 1992223762 | Jessica Katherine Hall | Emergency Medicine | 11800 E 12 Mile Rd, Warren, MI 48093-3472 | 2017-08-31 |
| 1689102535 | Gurtejbir Singh Bilkhu | Emergency Medicine | 12000 E 12 Mile Rd, Warren, MI 48093-3570 | 2017-05-23 |
| Find all providers in WARREN | ||||
Please comment or provide details below to improve the information on ST JOHN MACOMB OAKLAND HOSPITAL.
| 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.