NPIMap

Organization Active NPI

St. John Macomb Hospital

  • General Acute Care Hospital
  • Warren, MI
National Provider Identifier
1164584256
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
5601003607 Issued in MI
Legal business name
ST. JOHN MACOMB HOSPITAL
Practice address
11800 E 12 Mile Rd
Warren, MI 48093-3472
Phone
(586) 573-5512
Fax
(586) 573-5148
NPI assigned
Dec 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Lingareddy Devireddy, M.D.
Title
Chief of Cardiology
Phone
(586) 574-0890

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 5601003607 MI Primary

Addresses

Primary practice location

11800 E 12 Mile Rd
Warren, MI 48093-3472

Mailing address

25320 Ronald CT
Oak Park, MI 48237-1327
Phone (248) 543-3063

National Provider Directory

National Provider Directory
Tax ID family
Ascension Macomb Oak Hosp36 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

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164584256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25320 RONALD CT",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482371327",
            "telephone_number": "248-543-3063"
        },
        {
            "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": "586-573-5512",
            "fax_number": "586-573-5148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOHN MACOMB HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEVIREDDY",
        "authorized_official_first_name": "LINGAREDDY",
        "authorized_official_title_or_position": "CHIEF OF CARDIOLOGY",
        "authorized_official_telephone_number": "586-574-0890",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MI",
            "license": "5601003607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 2020; 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.