Organization Active NPI

Saint Joseph Mercy Saline Hospital

  • Internal Medicine Physician
  • Saline, MI
National Provider Identifier
1487773347
Registry record updated Sep 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SAINT JOSEPH MERCY SALINE HOSPITAL
Practice address
400 W Russell St
Saline, MI 48176-1183
Phone
(734) 429-1500
NPI assigned
Mar 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2011

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

Authorized official

Name
Garry Faja
Title
President Ceo
Phone
(734) 712-3791

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X
Hospice and Palliative Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0002X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Molecular Genetic Pathology (Pathology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0007X
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0102X
Clinical Pathology/Laboratory Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0105X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X

Addresses

Primary practice location

400 W Russell St
Saline, MI 48176-1183

Mailing address

5301 E Huron River Dr
PO Box 993, MC 69504
Ypsilanti, MI 48197-1051
Phone (734) 712-3456

Other identifiers 2

IdentifierTypeStateIssuer
700H161140OtherMIBS BCN PATH, LAB
110H113860OtherBS BCN AOG SHS

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316563200000",
    "number": "1487773347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 E HURON RIVER DR",
            "address_2": "PO BOX 993, MC 69504",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971051",
            "telephone_number": "734-712-3456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W RUSSELL ST",
            "city": "SALINE",
            "state": "MI",
            "postal_code": "481761183",
            "telephone_number": "734-429-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT JOSEPH MERCY SALINE HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2011-09-21",
        "status": "A",
        "authorized_official_last_name": "FAJA",
        "authorized_official_first_name": "GARRY",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "734-712-3791"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Molecular Genetic Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS BCN PATH, LAB",
            "identifier": "700H161140",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS BCN AOG SHS",
            "identifier": "110H113860",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saline, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.