St John Macomb Oakland Hospital

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

ST JOHN MACOMB OAKLAND HOSPITAL

Practice address

7733 E Jefferson Ave
Detroit, MI 48214-3707

Phone

(313) 499-4000

NPI assigned

May 21, 2008

Last updated

Jun 25, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Randolph Kummler

Title

VP Finance

Phone

(586) 573-5910

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1326205964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28000 DEQUINDRE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480922468",
            "telephone_number": "586-753-0275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7733 E JEFFERSON AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482143707",
            "telephone_number": "313-499-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOHN MACOMB OAKLAND HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-21",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "KUMMLER",
        "authorized_official_first_name": "RANDOLPH",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "586-573-5910"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0H26306",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• St John Hospital Corporation
• St John Hospital Corporation
• St John Hosptial and Medical Center
• St John Macomb Oakland Hospital
• St John Macomb Oakland Hospital
• St John Macomb Oakland Hospital (St John Macomb Oakland Hospital - St John Detroit Riverview Center)
• St John Providence
• St John Providence Eastwood Clinic
• St John Providence Health Systems
• St John Senior Community

• Emergency Medicine Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Emergency Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.