NPIMap

Organization Active NPI

Henry Ford Health St. John Hospital

Doing business as St John Hospital and Medical Center

  • Rehabilitation Hospital Unit
  • Detroit, MI
National Provider Identifier
1023335544
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
Legal business name
HENRY FORD HEALTH ST. JOHN HOSPITAL
Doing business as
St John Hospital and Medical Center
Practice address
22101 Moross Rd
Detroit, MI 48236-2148
Phone
(313) 343-4000
NPI assigned
Apr 23, 2010
Last updated
Jul 16, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Robin Damschroder
Title
President, Val Based ENT & Cfo
Phone
(313) 876-8452

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X Primary

Addresses

Primary practice location

22101 Moross Rd
Detroit, MI 48236-2148

Mailing address

PO Box 670884
Detroit, MI 48267-0884
Phone (800) 999-5829

Other names 1

  • St John Hospital and Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101230000745 MI Part A Provider - Hospital 3173424082 2 other NPIs on this enrollment
Practice locations: Detroit, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023335544. Details of each certification follow.

Hospital certification: CCN 23T165

Legal name
HENRY FORD HEALTH ST. JOHN HOSPITAL
Doing business as
HENRY FORD HEALTH - ST. JOHN HOSPITAL
Organization structure
CorporationNon-profit
Enrollment address
22101 Moross Rd
Detroit, MI 48236-2148
Hospital Rehabilitation Unit
Hospital subgroups
Acute care, Rehabilitation unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Ascension St John HospitalCCN 23T165 · All quality measures
Ownership
Non-profit
Certified
Jul 1, 2010

National Provider Directory

National Provider Directory
Tax ID family
St Johns Hospital74 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 30

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Daniel J. Phelan Individual Corporate DirectorBoard Member Jan 1, 2022
Henry Ford Health System Organization, Troy, MI Non-profit, Chain home office, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Dec 18, 1987 100%
Charles McClure Individual Corporate DirectorBoard Member Jul 25, 2014
Robert R Lubera Individual Corporate DirectorBoard Member Jan 1, 2025
Barry G. Porter Individual Corporate DirectorBoard Member Jan 1, 2020
Steven Brian Bender Individual Corporate OfficerSecretary Oct 21, 2024
Gerardo Norcia Individual Corporate DirectorBoard Member Dec 1, 2023
Robert Riney Individual Corporate DirectorBoard Member Jul 1, 2022
Michael Rafferty Individual Corporate DirectorBoard Member Jan 1, 2020
Jeffrey Fall Individual Corporate DirectorBoard Member Jan 1, 2025
Farzan Siddiqui Individual Corporate DirectorBoard Member Jan 1, 2024
Marjorie Staten Individual Corporate OfficerAssistant Secretary Oct 21, 2024
Rhonda M Medows Individual Corporate DirectorBoard Member Jan 1, 2025
David Breen Individual Corporate DirectorBoard Member Jan 1, 2015
Mary Ann Victor Individual Corporate DirectorBoard Member Jan 1, 2025
Jason Williams Individual W-2 Managing Employee Oct 1, 2024
Anthony Rocco Tersigni Individual Corporate DirectorBoard Member Oct 1, 2024
Robin S. Damschroder Individual Corporate OfficerTreasurer Oct 1, 2024
Operational/Managerial ControlTreasurer Oct 1, 2024
Calvin R Ford Individual Corporate DirectorBoard Member Jan 1, 2025
Gregory Pflum Individual Corporate DirectorBoard Member Sep 1, 2025
Henry Ford Health Parent Organization, Detroit, MI Created for acquisition, Non-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2024 80%
Edward D Callaghan Individual Corporate DirectorBoard Member Jan 1, 2025
John F. Harris Individual Corporate DirectorBoard Member Jan 1, 2021
Ascension Health Organization, Saint Louis, MO Non-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2024 20%
Edgar Vann Individual Corporate DirectorBoard Member Jan 1, 2015
Lisa Fitzpatrick Individual Corporate DirectorBoard Member Jan 1, 2025
Joseph Richardson Individual Corporate DirectorBoard Member Jan 1, 2016
Gwendolyn M Mackenzie Individual Corporate DirectorBoard Member Jan 1, 2025
Jacalyn S. Goforth Individual Corporate DirectorBoard Member Jan 1, 2022
Eugene F Lovasco Individual Corporate DirectorBoard Member Oct 1, 2024

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 159

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 159

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784160000000",
    "number": "1023335544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 670884",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482670884",
            "telephone_number": "800-999-5829",
            "fax_number": "248-641-4840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22101 MOROSS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362148",
            "telephone_number": "313-343-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY FORD HEALTH ST. JOHN HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-23",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A",
        "authorized_official_last_name": "DAMSCHRODER",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "PRESIDENT, VAL BASED ENT & CFO",
        "authorized_official_telephone_number": "313-876-8452"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St John Hospital and Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.