St. John Providence Health System

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

Legal business name

ST. JOHN PROVIDENCE HEALTH SYSTEM

Practice address

28000 Dequindre Rd
Warren, MI 48092-2468

Phone

(586) 753-0054

NPI assigned

Jun 17, 2014

Organization subpart

No

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

Authorized official

Name

Mrs. Dawn Kelel

Title

Manager

Phone

(586) 753-0054

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402963200000",
    "number": "1477967446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28000 DEQUINDRE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480922468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28000 DEQUINDRE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480922468",
            "telephone_number": "586-753-0054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOHN PROVIDENCE HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-17",
        "last_updated": "2014-06-17",
        "status": "A",
        "authorized_official_last_name": "KELEL",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "586-753-0054",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St. John Macomb-Oakland Hospital
• St. John Macomb-Oakland Hospital
• St. John Neurological Recovery Systems
• St. John Providence
• St. John Providence Health System
• St. John Providence Macomb/Oakland
• Emma St. Louis, BA
• Carley Palmer Stacy, MA CCC-SLP
• Laura Ann Stanjones, MA, LPC
• Amari Staple

• General Acute Care Hospital in Warren, MI
• Providers in Warren, MI by specialty
• General Acute Care Hospital in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2014; 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.