NPIMap

Organization Active NPI

St John Senior Community

  • Skilled Nursing Facility
  • Detroit, MI
National Provider Identifier
1700865169
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
BHS834032 Issued in MI
Legal business name
ST JOHN SENIOR COMMUNITY
Practice address
18300 E Warren
Detroit, MI 48224
Phone
(313) 343-8000
Fax
(313) 343-8959
NPI assigned
Jan 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Tomasine F Marx
Title
Vice President Finance
Phone
(586) 753-0310

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X BHS834032 MI Primary

Addresses

Primary practice location

18300 E Warren
Detroit, MI 48224

Mailing address

28000 Dequindre
Warren, MI 48092
Phone (586) 753-0310

Other identifiers 1

IdentifierTypeStateIssuer
09900OtherBCBS

National Provider Directory

National Provider Directory
Tax ID family
Ccla 9 LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1137110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700865169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28000 DEQUINDRE",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "48092",
            "telephone_number": "586-753-0310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18300 E WARREN",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48224",
            "telephone_number": "313-343-8000",
            "fax_number": "313-343-8959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOHN SENIOR COMMUNITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARX",
        "authorized_official_first_name": "TOMASINE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "VICE PRESIDENT FINANCE",
        "authorized_official_telephone_number": "586-753-0310"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MI",
            "license": "BHS834032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "09900",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.