NPIMap

Organization Active NPI

St. John Providence Macomb/Oakland

  • Psychiatric Hospital
  • Warren, MI
National Provider Identifier
1477846293
Registry record updated May 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
6802070800 Issued in MI
Legal business name
ST. JOHN PROVIDENCE MACOMB/OAKLAND
Practice address
11800 E 12 Mile Rd
Warren, MI 48093-3472
Phone
(585) 573-5300
NPI assigned
May 26, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2011

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

Authorized official

Name
Dr. Bal K Gupta, M.D.
Title
Director of Behaviorial Medicine
Phone
(586) 573-5300

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X 6401002292 MI
Psychiatric Hospital 283Q00000X 6802070800 MI Primary

Addresses

Primary practice location

11800 E 12 Mile Rd
Warren, MI 48093-3472

Mailing address

11800 E 12 Mile Rd
Warren, MI 48093-3472
Phone (585) 573-5300

National Provider Directory

National Provider Directory
Tax ID family
Ascension Macomb Oak Hosp36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1306368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306368000000",
    "number": "1477846293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11800 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933472",
            "telephone_number": "585-573-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933472",
            "telephone_number": "585-573-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOHN PROVIDENCE MACOMB/OAKLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-26",
        "last_updated": "2011-05-26",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "BAL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "DIRECTOR OF BEHAVIORIAL MEDICINE",
        "authorized_official_telephone_number": "586-573-5300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "MI",
            "license": "6401002292",
            "primary": false
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "MI",
            "license": "6802070800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2011; 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.