NPIMap

Organization Active NPI

Saint Joseph Mercy Livingston Hospital

  • Psychiatry Physician
  • Brighton, MI
National Provider Identifier
1306059811
Registry record updated Jan 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
SAINT JOSEPH MERCY LIVINGSTON HOSPITAL
Practice address
2300 Genoa Business Park Dr
Suite 180
Brighton, MI 48114-7367
Phone
(810) 844-7300
NPI assigned
May 8, 2007
Last updated
Jan 13, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
TRINITY HEALTH - MICHIGANAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 13, 2017

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

Authorized official

Name
Michael Gusho
Title
SE Mi Regional C.F.O.
Phone
(734) 398-0642

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X
Clinical Social Worker 1041C0700X
Marriage & Family Therapist 106H00000X
Psychiatry Physician 2084P0800X Primary
Prescribing (Medical) Psychologist 103TP0016X

Addresses

Primary practice location

2300 Genoa Business Park Dr
Suite 180
Brighton, MI 48114-7367

Mailing address

34505 W 12 Mile Rd
Suite 200
Farmington Hills, MI 48331-3258
Phone (734) 343-3923

Other identifiers 1

IdentifierTypeStateIssuer
10435OtherMIBLUE CROSS

National Provider Directory

National Provider Directory
Tax ID family
McPherson Hosp13 organizations share this tax ID, including this one
Part of
Mercy Health Center

Other organizations with this tax ID 12

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

Locations

2300 Genoa Business Park Dr
Ste 180
Brighton, MI 48114
Phone (734) 786-2300

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484265600000",
    "number": "1306059811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34505 W 12 MILE RD",
            "address_2": "SUITE 200",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483313258",
            "telephone_number": "734-343-3923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 GENOA BUSINESS PARK DR",
            "address_2": "SUITE 180",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481147367",
            "telephone_number": "810-844-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT JOSEPH MERCY LIVINGSTON HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRINITY HEALTH - MICHIGAN",
        "enumeration_date": "2007-05-08",
        "last_updated": "2017-01-13",
        "status": "A",
        "authorized_official_last_name": "GUSHO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "SE MI REGIONAL C.F.O.",
        "authorized_official_telephone_number": "734-398-0642"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "10435",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2017; 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.