NPIMap

Organization Active NPI

St Joseph Mercy Hospital

  • Maternal & Fetal Medicine Physician
  • Ypsilanti, MI
National Provider Identifier
1407094600
Registry record updated Oct 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
Legal business name
ST JOSEPH MERCY HOSPITAL
Practice address
5333 McAuley Drive
Suite 2110
Ypsilanti, MI 48197-1051
Phone
(734) 712-4017
NPI assigned
Jan 26, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2017

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

Authorized official

Name
Michael P Gusho
Title
Cfo SE Mi Region
Phone
(248) 858-6174

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VM0101X Primary

Addresses

Primary practice location

5333 McAuley Drive
Suite 2110
Ypsilanti, MI 48197-1051

Mailing address

34505 W 12 Mile Rd Ste 200
Farmington Hills, MI 48331-3286
Phone (734) 343-3922

Other identifiers 1

IdentifierTypeStateIssuer
7700000001OtherMIMI MEDICAID-MATERNAL INFANT HEALTH PROGRAM

National Provider Directory

National Provider Directory
Tax ID family
Seniroe Health Services25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1232928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507161600000",
    "number": "1407094600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34505 W 12 MILE RD STE 200",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483313286",
            "telephone_number": "734-343-3922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5333 MCAULEY DRIVE",
            "address_2": "SUITE 2110",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971051",
            "telephone_number": "734-712-4017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOSEPH MERCY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-26",
        "last_updated": "2017-10-05",
        "status": "A",
        "authorized_official_last_name": "GUSHO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CFO SE MI REGION",
        "authorized_official_telephone_number": "248-858-6174"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI MEDICAID-MATERNAL INFANT HEALTH PROGRAM",
            "identifier": "7700000001",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.