NPIMap

Organization Active NPI

Henry Ford Health River District Hospital

Doing business as Henry Ford River District Hospital

  • Family Medicine Physician
  • East China, MI
National Provider Identifier
1265486245
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HENRY FORD HEALTH RIVER DISTRICT HOSPITAL
Doing business as
Henry Ford River District Hospital
Practice address
4100 S River Rd
East China, MI 48054-2909
Phone
(800) 848-0202
Fax
(586) 226-6949
NPI assigned
May 22, 2006
Last updated
Jul 16, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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

Authorized official

Name
Kimberly Cebalt
Title
Director
Phone
(313) 874-6764

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MI Primary
Adolescent Medicine (Family Medicine) Physician 207QA0000X MI
Adult Medicine Physician 207QA0505X MI
Endocrinology, Diabetes & Metabolism Physician 207RE0101X MI
Infectious Disease Physician 207RI0200X MI
Obstetrics & Gynecology Physician 207V00000X MI
Gynecology Physician 207VG0400X MI
Maternal & Fetal Medicine Physician 207VM0101X MI
Obstetrics Physician 207VX0000X MI
Otolaryngology Physician 207Y00000X MI
Pediatric Otolaryngology Physician 207YP0228X MI
Facial Plastic Surgery Physician 207YS0123X MI
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X MI
Otolaryngic Allergy Physician 207YX0602X MI
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X MI

Addresses

Primary practice location

4100 S River Rd
East China, MI 48054-2909

Mailing address

PO Box 670884
Detroit, MI 48267-0884
Phone (800) 999-5829

Other names 2

  • Henry Ford River District Hospital Doing business as
  • St. John River District physician practices Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040203000465 MI Part B Supplier - Clinic/Group Practice 0446153407 Receives reassigned benefits from 32 practitioners
1 other NPI on this enrollment
Practice locations: East China, MI; Saint Clair, MI; Riley, MI; Marysville, MI; Algonac, MI

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2324130Henry Ford River District Hospital Radiology4100 River Road, East China, MI 48054Certificate of waiverMay 19, 2027

National Provider Directory

National Provider Directory

Locations

2292 Solution Ctr
Chicago, IL 60677

2700 Pointe Tremble Rd
#406
Algonac, MI 48001
Phone (810) 794-9324

2700 Pointe Tremble Rd
Ste B
Algonac, MI 48001

4014 River Rd
Ste 3
East China, MI 48054

4100 River Rd
Bldg 6
East China, MI 48054

4150 S River Rd
Ste 2E
East China, MI 48054

4150 S River Rd
Ste E
East China, MI 48054
Phone (810) 326-2018

Practitioners & affiliated clinicians

Practitioners 42

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784160000000",
    "number": "1265486245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 670884",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482670884",
            "telephone_number": "800-999-5829",
            "fax_number": "248-641-4840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 S RIVER RD",
            "city": "EAST CHINA",
            "state": "MI",
            "postal_code": "480542909",
            "telephone_number": "800-848-0202",
            "fax_number": "586-226-6949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY FORD HEALTH RIVER DISTRICT HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A",
        "authorized_official_last_name": "CEBALT",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "313-874-6764"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": null,
            "primary": true
        },
        {
            "code": "207QA0000X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "MI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Henry Ford River District Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. John River District physician practices",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in East China, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.