NPIMap

Organization Active NPI

St Clair Cardiovascular Surgeons PLC

  • Cardiovascular Disease Physician
  • Roseville, MI
National Provider Identifier
1194714980
Registry record updated Oct 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
ST CLAIR CARDIOVASCULAR SURGEONS PLC
Practice address
25599 Kelly Rd
Ste a
Roseville, MI 48066-4975
Phone
(586) 772-6000
Fax
(586) 772-7700
NPI assigned
Oct 14, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2007

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

Authorized official

Name
C. Douglas Lees, MD
Title
Trustee
Phone
(586) 772-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

25599 Kelly Rd
Ste a
Roseville, MI 48066-4975

Mailing address

25599 Kelly Rd
Ste a
Roseville, MI 48066-4975
Phone (586) 772-6000

National Provider Directory

National Provider Directory

Locations

22151 Moross Rd
#620
Detroit, MI 48236
Phone (313) 343-0505

22151 Moross Rd
Ste G20
Grosse Pointe, MI 48236
Phone (313) 343-0505

1221 Pine Grove Ave
Fl 6
Port Huron, MI 48060

1117 Stone St
Ste 1
Port Huron, MI 48060
Phone (810) 488-8480

25599 Kelly Rd
Ste A
Roseville, MI 48066
Phone (586) 772-6000

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191974400000",
    "number": "1194714980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25599 KELLY RD",
            "address_2": "STE A",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664975",
            "telephone_number": "586-772-6000",
            "fax_number": "586-772-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25599 KELLY RD",
            "address_2": "STE A",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664975",
            "telephone_number": "586-772-6000",
            "fax_number": "586-772-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST CLAIR CARDIOVASCULAR SURGEONS PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-14",
        "last_updated": "2007-10-10",
        "status": "A",
        "authorized_official_last_name": "LEES",
        "authorized_official_first_name": "C. DOUGLAS",
        "authorized_official_title_or_position": "TRUSTEE",
        "authorized_official_telephone_number": "586-772-6000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; 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.