NPIMap

Organization Active NPI

St John Medical Center Macomb Township

  • Urgent Care Clinic/Center
  • Macomb, MI
National Provider Identifier
1083746820
Registry record updated Dec 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
ST JOHN MEDICAL CENTER MACOMB TOWNSHIP
Practice address
17700 23 Mile Rd
Macomb, MI 48044-1154
Phone
(586) 753-0011
NPI assigned
Mar 9, 2007
Last updated
Dec 3, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2010

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

Authorized official

Name
Ms. Tomasine Marx
Title
Cfo
Phone
(313) 343-7676

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

17700 23 Mile Rd
Macomb, MI 48044-1154

Mailing address

28000 Dequindre Rd
Warren, MI 48092-2468
Phone (586) 753-0011

Other identifiers 1

IdentifierTypeStateIssuer
0E01417OtherMIBLUE CARE NETWORK PIN

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291334400000",
    "number": "1083746820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28000 DEQUINDRE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480922468",
            "telephone_number": "586-753-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17700 23 MILE RD",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480441154",
            "telephone_number": "586-753-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOHN MEDICAL CENTER MACOMB TOWNSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2010-12-03",
        "status": "A",
        "authorized_official_last_name": "MARX",
        "authorized_official_first_name": "TOMASINE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "313-343-7676",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK PIN",
            "identifier": "0E01417",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macomb, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.