NPIMap

Organization Active NPI

Open MRI of Michigan LLC

  • Diagnostic Radiology Physician
  • Madison Heights, MI
National Provider Identifier
1275570848
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
OPEN MRI OF MICHIGAN LLC
Practice address
411 W 13 Mile Rd
Ste 200
Madison Heights, MI 48071-1526
Phone
(248) 585-4569
Fax
(248) 585-4620
NPI assigned
Jun 1, 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
Ronald W Jesmore
Title
Corporate Director
Phone
(586) 226-6987

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X MI Primary

Addresses

Primary practice location

411 W 13 Mile Rd
Ste 200
Madison Heights, MI 48071-1526

Mailing address

PO Box 67000
Department 18401
Detroit, MI 48267-1841
Phone (586) 228-4607

Other identifiers 12

IdentifierTypeStateIssuer
0F30087OtherBCBS
8265OtherCAPE
P116959OtherBCN OLD PROVIDER #
0N68190OtherHAP
139709OtherGREAT LAKES HEALTH PLAN
7282452OtherAETNA
001269OtherMIDWEST HEALTH PLAN
135843OtherCARE CHOICES
8263818OtherCIGNA
QMXPR0021565OtherMOLINA
M1670OtherONE CALL MEDICAL
RA16206OtherMCARE

Other names 1

  • St John Open MRI of Michigan LLC Other name

National Provider Directory

National Provider Directory

Locations

411 W 13 Mile Rd
Ste 200
Madison Hts, MI 48071
Phone (248) 585-4569

2800 Livernois Rd
Ste 500B
Troy, MI 48083

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275570848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67000",
            "address_2": "DEPARTMENT 18401",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482671841",
            "telephone_number": "586-228-4607",
            "fax_number": "586-228-4666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 W 13 MILE RD",
            "address_2": "STE 200",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480711526",
            "telephone_number": "248-585-4569",
            "fax_number": "248-585-4620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN MRI OF MICHIGAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JESMORE",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CORPORATE DIRECTOR",
        "authorized_official_telephone_number": "586-226-6987"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0F30087",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPE",
            "identifier": "8265",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN OLD PROVIDER #",
            "identifier": "P116959",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP",
            "identifier": "0N68190",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT LAKES HEALTH PLAN",
            "identifier": "139709",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7282452",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDWEST HEALTH PLAN",
            "identifier": "001269",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES",
            "identifier": "135843",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8263818",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA",
            "identifier": "QMXPR0021565",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ONE CALL MEDICAL",
            "identifier": "M1670",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCARE",
            "identifier": "RA16206",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St John Open MRI of Michigan LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 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.