NPIMap

Organization Active NPI

St. Joseph Mercy Hospital

  • Gynecologic Oncology Physician
  • Ypsilanti, MI
National Provider Identifier
1114930997
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
Legal business name
ST. JOSEPH MERCY HOSPITAL
Practice address
5333 McAuley Dr
Suite 4015
Ypsilanti, MI 48197-1014
Phone
(734) 712-5733
NPI assigned
Aug 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Authorized official

Name
Rolland Mambourg, M.D.
Title
Vice President Physician Relations
Phone
(734) 712-7358

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VX0201X Primary

Addresses

Primary practice location

5333 McAuley Dr
Suite 4015
Ypsilanti, MI 48197-1014

Mailing address

5333 McAuley Dr
Suite 4015
Ypsilanti, MI 48197-1014

Other names 1

  • CMHSC- Gyn Oncology Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1114930997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5333 MCAULEY DR",
            "address_2": "SUITE 4015",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5333 MCAULEY DR",
            "address_2": "SUITE 4015",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971014",
            "telephone_number": "734-712-5733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOSEPH MERCY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "MAMBOURG",
        "authorized_official_first_name": "ROLLAND",
        "authorized_official_title_or_position": "VICE PRESIDENT PHYSICIAN RELATIONS",
        "authorized_official_telephone_number": "734-712-7358",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CMHSC- Gyn Oncology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ypsilanti, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.