NPIMap

Organization Active NPI

St John Health System

  • Cognitive & Behavioral Psychologist
  • Madison Heights, MI
National Provider Identifier
1255451456
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
Legal business name
ST JOHN HEALTH SYSTEM
Doing business as
St John Health Chronic Headache and MIgraine Institute
Practice address
27483 Dequindre Rd
Suite 306
Madison Heights, MI 48071-3491
Phone
(248) 967-7988
Fax
(248) 967-7991
NPI assigned
Mar 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Sandra Ellen Whitman
Title
Director-Physician Billing Services
Phone
(248) 746-3218

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TB0200X Primary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X

Addresses

Primary practice location

27483 Dequindre Rd
Suite 306
Madison Heights, MI 48071-3491

Mailing address

25925 Telegraph Rd
210
Southfield, MI 48034-2518
Phone (248) 746-3218

Other identifiers 1

IdentifierTypeStateIssuer
680F33073OtherMIBCBSM GROUP PIN

Other names 1

  • St John Health Chronic Headache and MIgraine Institute Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Coor Samue5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1255451456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25925 TELEGRAPH RD",
            "address_2": "210",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480342518",
            "telephone_number": "248-746-3218",
            "fax_number": "248-746-0369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27483 DEQUINDRE RD",
            "address_2": "SUITE 306",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480713491",
            "telephone_number": "248-967-7988",
            "fax_number": "248-967-7991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOHN HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "WHITMAN",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "DIRECTOR-PHYSICIAN BILLING SERVICES",
        "authorized_official_telephone_number": "248-746-3218"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM GROUP PIN",
            "identifier": "680F33073",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St John Health Chronic Headache and MIgraine Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Madison Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.