Surgical Specialists of St. Joseph, P.C.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

SURGICAL SPECIALISTS OF ST. JOSEPH, P.C.

Practice address

2990 Niles Rd
Saint Joseph, MI 49085-8607

Phone

(269) 983-3368

Fax

(269) 983-2758

NPI assigned

Dec 13, 2006

Last updated

Jul 20, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jacquelyn A. Hastings

Title

Administrator

Phone

(269) 983-3368

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311120000000",
    "number": "1144382789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2990 NILES RD",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490858607",
            "telephone_number": "269-983-3368",
            "fax_number": "269-983-2758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2990 NILES RD",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490858607",
            "telephone_number": "269-983-3368",
            "fax_number": "269-983-2758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL SPECIALISTS OF ST. JOSEPH, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2011-07-20",
        "status": "A",
        "authorized_official_last_name": "HASTINGS",
        "authorized_official_first_name": "JACQUELYN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "269-983-3368"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "020A110340",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2011; 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.