NPIMap

Organization Active NPI

Henry Ford Health Macomb Oakland Hospital

Doing business as St. John Macomb Oakland Hospital-Warren Campus

  • General Acute Care Hospital
  • Warren, MI
National Provider Identifier
1124099858
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
HENRY FORD HEALTH MACOMB OAKLAND HOSPITAL
Doing business as
St. John Macomb Oakland Hospital-Warren Campus
Practice address
11800 E 12 Mile Rd
Warren, MI 48093
Phone
(586) 573-5000
NPI assigned
Jan 31, 2006
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
General Acute Care Hospital 282N00000X NU Primary

Addresses

Primary practice location

11800 E 12 Mile Rd
Warren, MI 48093

Mailing address

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

Other practice location 1

27351 Dequindre Rd
Madison Heights, MI 48071-3487
Phone (248) 967-7000

Other identifiers 1

IdentifierTypeStateIssuer
00048OtherBLUE CROSS PIN

Other names 1

  • St. John Macomb Oakland Hospital-Warren Campus Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070615000155 MI Part A Provider - Hospital 7315859725 1 other NPI on this enrollment
Practice locations: Warren, MI; Madison Heights, MI; Detroit, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1124099858. Details of each certification follow.

Hospital certification: CCN 230195

Legal name
HENRY FORD HEALTH MACOMB OAKLAND HOSPITAL
Doing business as
HENRY FORD HEALTH WARREN HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Mar 9, 2010
Beds
348
Ownership / control type
Private (not for profit)
Most recent change of ownership
Jul 1, 1997 (1 total)
Organization structure
CorporationNon-profit
Enrollment address
11800 E 12 Mile Rd
Warren, MI 48093-3472
Main/Primary Hospital Location
Hospital subgroups
Acute care

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

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Henry Ford Health Warren HospitalCCN 230195 · All quality measures
Overall star rating
1 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Detroit Macomb-Oakland Hospital Corporation36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

Organizations that report the same tax identification number in the National Provider Directory.

View all 35

Member of 1

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

Locations

3195 Solutions Ctr
#773195
Chicago, IL 60677

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 Jan 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 66

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.

View all 66

Affiliated clinicians 727

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

View all 727

NPI Registry JSON

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784160000000",
    "number": "1124099858",
    "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": "11800 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "48093",
            "telephone_number": "586-573-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27351 Dequindre Rd",
            "address_purpose": "LOCATION",
            "city": "Madison Heights",
            "state": "MI",
            "postal_code": "480713487",
            "country_code": "US",
            "telephone_number": "248-967-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HENRY FORD HEALTH MACOMB OAKLAND HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-31",
        "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": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PIN",
            "identifier": "00048",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. John Macomb Oakland Hospital-Warren Campus",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. John Macomb Oakland Hospital-Warren Campus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.