NPIMap

Organization Active NPI

St. John Macomb-Oakland Hospital

Doing business as Oculoplastic, Orbital & Neuro-Ophthalmic Surgery

  • Ophthalmology Physician
  • Warren, MI
National Provider Identifier
1497063325
Registry record updated Sep 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
ST. JOHN MACOMB-OAKLAND HOSPITAL
Doing business as
Oculoplastic, Orbital & Neuro-Ophthalmic Surgery
Practice address
27450 Schoenherr Rd
Suite 200
Warren, MI 48088-6683
Phone
(586) 582-7860
Fax
(586) 582-7861
NPI assigned
Sep 14, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2010

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

Authorized official

Name
Jennifer Johnson
Title
Director
Phone
(586) 228-4560

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207T00000X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary
Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208200000X
Plastic and Reconstructive Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0122X

Addresses

Primary practice location

27450 Schoenherr Rd
Suite 200
Warren, MI 48088-6683

Mailing address

27450 Schoenherr Rd
Suite 200
Warren, MI 48088-6683
Phone (586) 582-7860

Other identifiers 1

IdentifierTypeStateIssuer
180E01180OtherMIBCBS GROUP

Other names 1

  • Oculoplastic, Orbital & Neuro-Ophthalmic Surgery Doing business as

National Provider Directory

National Provider Directory
Tax ID family
St John Macomb Hospital36 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": "1284422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284422400000",
    "number": "1497063325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27450 SCHOENHERR RD",
            "address_2": "SUITE 200",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480886683",
            "telephone_number": "586-582-7860",
            "fax_number": "586-582-7861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27450 SCHOENHERR RD",
            "address_2": "SUITE 200",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480886683",
            "telephone_number": "586-582-7860",
            "fax_number": "586-582-7861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOHN MACOMB-OAKLAND HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-14",
        "last_updated": "2010-09-14",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "586-228-4560"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "180E01180",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oculoplastic, Orbital & Neuro-Ophthalmic Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 14, 2010; 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.