NPIMap

Organization Active NPI

St. John Hospital and Medical Center

Doing business as Masonic Urgent Care Center

  • Urgent Care Clinic/Center
  • Saint Clair Shores, MI
National Provider Identifier
1386892834
Registry record updated Dec 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
ST. JOHN HOSPITAL AND MEDICAL CENTER
Doing business as
Masonic Urgent Care Center
Practice address
21099 Masonic Blvd
Saint Clair Shores, MI 48082-1045
Phone
(586) 296-6213
Fax
(586) 296-8180
NPI assigned
Sep 8, 2008
Last updated
Dec 12, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2012

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

Authorized official

Name
Jennifer Johnson
Title
Director
Phone
(586) 228-4560

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X MI Primary
Family Medicine Physician 207Q00000X MI

Addresses

Primary practice location

21099 Masonic Blvd
Saint Clair Shores, MI 48082-1045

Mailing address

21099 Masonic Blvd
Saint Clair Shores, MI 48082-1045
Phone (586) 296-6213

Other identifiers 3

IdentifierTypeStateIssuer
700E034110OtherMIBCBS GROUP NUMBER
700E014700OtherMIBCBS GROUP NUMBER
700E031610OtherMIBCBS GROUP NUMBER

Other names 1

  • Masonic Urgent Care Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
St Johh Hospital Corp74 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 11

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": "1220832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355270400000",
    "number": "1386892834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21099 MASONIC BLVD",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480821045",
            "telephone_number": "586-296-6213",
            "fax_number": "586-296-8180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21099 MASONIC BLVD",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480821045",
            "telephone_number": "586-296-6213",
            "fax_number": "586-296-8180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOHN HOSPITAL AND MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-08",
        "last_updated": "2012-12-12",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "586-228-4560"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "MI",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "700E034110",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "700E014700",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "700E031610",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Masonic Urgent Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2012; 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.