NPIMap

Organization Active NPI

St. John Providence Health System

  • General Acute Care Hospital
  • Warren, MI
National Provider Identifier
1154612745
Registry record updated Apr 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
6401007085 Issued in MI
Legal business name
ST. JOHN PROVIDENCE HEALTH SYSTEM
Practice address
11800 E 12 Mile Rd
Warren, MI 48093-3472
Phone
(586) 573-5872
Fax
(586) 573-5583
NPI assigned
Apr 29, 2011
Organization subpart
Yes
Parent organization
ST. JOHN PROVIDENCE HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 29, 2011

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

Authorized official

Name
Mrs. Christina Maria Pope, MA LPC
Title
Behavioral Health Intake Clinician
Phone
(586) 573-5872

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 6401007085 MI Primary

Addresses

Primary practice location

11800 E 12 Mile Rd
Warren, MI 48093-3472

Mailing address

11800 East Twelve Mile Road
Warren, MI 48093
Phone (586) 573-5872

Other names 1

  • St. John Macomb Hospital Other name

National Provider Directory

National Provider Directory
Tax ID family
Ascension Macomb Oak Hosp36 organizations share this tax ID, including this one
Part of
Ascension Macomb Oak Hosp

Other organizations with this tax ID 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1304035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304035200000",
    "number": "1154612745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11800 EAST TWELVE MILE ROAD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "48093",
            "telephone_number": "586-573-5872",
            "fax_number": "586-573-5583"
        },
        {
            "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": "480933472",
            "telephone_number": "586-573-5872",
            "fax_number": "586-573-5583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOHN PROVIDENCE HEALTH SYSTEM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. JOHN PROVIDENCE HEALTH SYSTEM",
        "enumeration_date": "2011-04-29",
        "last_updated": "2011-04-29",
        "status": "A",
        "authorized_official_last_name": "POPE",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "BEHAVIORAL HEALTH INTAKE CLINICIAN",
        "authorized_official_telephone_number": "586-573-5872",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA LPC"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MI",
            "license": "6401007085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. John Macomb Hospital",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.