NPIMap

Organization Active NPI

Sacred Heart Rehabilitation Center, Inc.

  • Community/Behavioral Health Agency
  • Saint Clair Shores, MI
National Provider Identifier
1093282881
Registry record updated Jan 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SACRED HEART REHABILITATION CENTER, INC.
Practice address
19611 E 8 Mile Rd
Saint Clair Shores, MI 48080-1655
Phone
(586) 541-3550
NPI assigned
Oct 30, 2018
Last updated
Jan 2, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
SACRED HEART REHABILITATION CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 2, 2019

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

Authorized official

Name
Tammy Murray
Title
Administrative Assistant
Phone
(810) 392-2167

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

19611 E 8 Mile Rd
Saint Clair Shores, MI 48080-1655

Mailing address

400 Stoddard Rd
Richmond, MI 48062-2505
Phone (810) 392-2167

Other identifiers 1

IdentifierTypeStateIssuer
SA0500499OtherMISTATE LICENSE

Other names 1

  • Sacred Heart-St. Clair Shores OP Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments
Opioid treatment program
Medicare-enrolled since Jan 1, 2020

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050712000553 MI Part B Supplier - Clinic/Group Practice 5395771240 Receives reassigned benefits from 37 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bay City, MI; Saint Ignace, MI; Saint Clair Shores, MI; Saginaw, MI; Richmond, MI; Port Huron, MI; Madison Heights, MI; Flint, MI…
O20200302001466 MI Part B Supplier - Opioid Treatment Program (Otp) 5395771240 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Saint Clair Shores, MI; Saint Ignace, MI; Richmond, MI; Madison HTS, MI; Flint, MI

Other NPIs on the same Medicare enrollment 13

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

View all 13

National Provider Directory

National Provider Directory
Part of
Sacred Heart Rehabilitation Center Inc

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1540857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546387200000",
    "number": "1093282881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 STODDARD RD",
            "city": "RICHMOND",
            "state": "MI",
            "postal_code": "480622505",
            "telephone_number": "810-392-2167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19611 E 8 MILE RD",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801655",
            "telephone_number": "586-541-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRED HEART REHABILITATION CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SACRED HEART REHABILITATION CENTER, INC.",
        "enumeration_date": "2018-10-30",
        "last_updated": "2019-01-02",
        "status": "A",
        "authorized_official_last_name": "MURRAY",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "810-392-2167"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "SA0500499",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sacred Heart-St. Clair Shores OP",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Sacred Heart-St. Clair Shores OP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.