NPIMap

Organization Active NPI

St John Health System Oakland

  • Anatomic Pathology & Clinical Pathology Physician
  • Madison Heights, MI
National Provider Identifier
1366470908
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
ST JOHN HEALTH SYSTEM OAKLAND
Practice address
27351 Dequindre
Madison Heights, MI 48071-3487
Phone
(248) 967-7750
Fax
(248) 967-7297
NPI assigned
Jun 30, 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
Evette N Elsenety, MDNPI 1164468500
Title
Director of Pathology
Phone
(248) 967-7750

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X Primary

Addresses

Primary practice location

27351 Dequindre
Madison Heights, MI 48071-3487

Mailing address

PO Box 673062
Detroit, MI 48267-3062
Phone (248) 967-7750

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366470908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 673062",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482673062",
            "telephone_number": "248-967-7750",
            "fax_number": "248-967-7297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27351 DEQUINDRE",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480713487",
            "telephone_number": "248-967-7750",
            "fax_number": "248-967-7297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOHN HEALTH SYSTEM OAKLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELSENETY",
        "authorized_official_first_name": "EVETTE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "DIRECTOR OF PATHOLOGY",
        "authorized_official_telephone_number": "248-967-7750",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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.