NPIMap

Organization Active NPI

St Joseph Mercy Hospital

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Ypsilanti, MI
National Provider Identifier
1174720080
Registry record updated Oct 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Hospital UnitTaxonomy code 276400000X
License
810349 Issued in MI
Legal business name
ST JOSEPH MERCY HOSPITAL
Practice address
5401 McAuley Drive
Ypsilanti, MI 48197-1011
Phone
(734) 712-3456
NPI assigned
Jul 3, 2007
Last updated
Oct 5, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2017

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

Authorized official

Name
Michael P Gusho
Title
Cfo SE Mi Region
Phone
(248) 858-6174

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Hospital Unit 276400000X 810349 MI Primary

Addresses

Primary practice location

5401 McAuley Drive
Ypsilanti, MI 48197-1011

Mailing address

34505 W 12 Mile Rd Ste 200
Farmington Hills, MI 48331-3286
Phone (734) 343-3922

Other identifiers 1

IdentifierTypeStateIssuer
21142OtherMIBLUE CROSS OP SUB ABUSE

National Provider Directory

National Provider Directory
Tax ID family
St Joseph Mercy Hospital25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507161600000",
    "number": "1174720080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34505 W 12 MILE RD STE 200",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483313286",
            "telephone_number": "734-343-3922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 MCAULEY DRIVE",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971011",
            "telephone_number": "734-712-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOSEPH MERCY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-03",
        "last_updated": "2017-10-05",
        "status": "A",
        "authorized_official_last_name": "GUSHO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CFO SE MI REGION",
        "authorized_official_telephone_number": "248-858-6174"
    },
    "taxonomies": [
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": "MI",
            "license": "810349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OP SUB ABUSE",
            "identifier": "21142",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Oct 5, 2017; 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.