NPIMap

Organization Active NPI

St. John Health System Oakland

  • Certified Registered Nurse Anesthetist
  • Madison Heights, MI
National Provider Identifier
1437187903
Registry record updated Sep 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
ST. JOHN HEALTH SYSTEM OAKLAND
Practice address
27351 Dequindre Rd
Madison Heights, MI 48071-3487
Phone
(810) 753-0185
NPI assigned
Jun 30, 2006
Organization subpart
Yes
Parent organization
ST. JOHN HEALTH SYSTEM OAKLANDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 19, 2007

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

Authorized official

Name
Jennifer Fennell
Title
Authorized Official
Phone
(810) 753-0185

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

27351 Dequindre Rd
Madison Heights, MI 48071-3487

Mailing address

255 W Michigan Ave
Jackson, MI 49201-2218
Phone (517) 787-6440

National Provider Directory

National Provider Directory
Tax ID family
Coor Samue5 organizations share this tax ID, including this one
Part of
Coor Samue

Other organizations with this tax ID 4

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

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": "1190160000000",
    "number": "1437187903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012218",
            "telephone_number": "517-787-6440",
            "fax_number": "517-787-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27351 DEQUINDRE RD",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480713487",
            "telephone_number": "810-753-0185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOHN HEALTH SYSTEM OAKLAND",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. JOHN HEALTH SYSTEM OAKLAND",
        "enumeration_date": "2006-06-30",
        "last_updated": "2007-09-19",
        "status": "A",
        "authorized_official_last_name": "FENNELL",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "810-753-0185"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "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 Sep 19, 2007; 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.