Organization Active NPI

Saint Joseph Clinic PC

  • Pain Medicine Physician
  • Southfield, MI
National Provider Identifier
1285974790
Registry record updated Feb 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
SAINT JOSEPH CLINIC PC
Practice address
23077 Greenfield Rd
Suite#240
Southfield, MI 48075-3709
Phone
(248) 809-6402
Fax
(248) 537-3012
NPI assigned
Feb 20, 2013
Last updated
Feb 20, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
SAINT JOSEPH CLINIC PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 20, 2013

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

Authorized official

Name
Mr. Srinivasulu Reddy
Title
Administrator
Phone
(248) 809-6402

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X NU Primary

Addresses

Primary practice location

23077 Greenfield Rd
Suite#240
Southfield, MI 48075-3709

Mailing address

23077 Greenfield Rd
Suite#240
Southfield, MI 48075-3709
Phone (248) 809-6402

National Provider Directory

National Provider Directory
Tax ID family
Saint Joseph Clinic PC2 organizations share this tax ID, including this one
Part of
Saint Joseph Clinic PC

Other organizations with this tax ID 1

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1361318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361318400000",
    "number": "1285974790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23077 GREENFIELD RD",
            "address_2": "SUITE#240",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753709",
            "telephone_number": "248-809-6402",
            "fax_number": "248-537-3012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23077 GREENFIELD RD",
            "address_2": "SUITE#240",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753709",
            "telephone_number": "248-809-6402",
            "fax_number": "248-537-3012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT JOSEPH CLINIC PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAINT JOSEPH CLINIC PC",
        "enumeration_date": "2013-02-20",
        "last_updated": "2013-02-20",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "SRINIVASULU",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "248-809-6402",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2013; 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.