St Johns Health Care PC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

ST JOHNS HEALTH CARE PC

Practice address

609 N Washington Ave
Ludington, MI 49431-1503

Phone

(231) 845-7922

Fax

(231) 843-8491

NPI assigned

Mar 6, 2007

Organization subpart

No

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

Authorized official

Name

Lisa Lynn Thompson, RN

Title

General Manager

Phone

(231) 845-7922

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Home health agency certification: CCN 239355

Legal name

ST JOHNS HEALTH CARE PC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Nov 21, 2023

Last certification

Nov 21, 2023

Organization structure

CorporationProprietary

Incorporated

May 6, 2004 in MI

Enrollment address

609 N Washington Ave
Ludington, MI 49431-1503

Listed as

St Johns Health Care, PCCCN 239355

Ownership

-

Certified

Nov 21, 2023

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272412800000",
    "number": "1700916335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 N WASHINGTON AVE",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494311503",
            "telephone_number": "231-845-7922",
            "fax_number": "231-843-8491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 N WASHINGTON AVE",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494311503",
            "telephone_number": "231-845-7922",
            "fax_number": "231-843-8491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOHNS HEALTH CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2010-04-28",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "231-845-7922",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154625029",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Spectrum Health Primary Care Partners
• Spectrum Health Primary Care Partners
• Spectrum Health Primary Care Partners
• Renee Sporer, LLMSW
• Alexus Squires, DPM
• Lori Mae Stakenas-Schneider, LMSW
• Barry G Stearns, LPC
• Aaron M Steinke, LMSW
• Lauren Sterley, PHARMD
• Vicky Stever, LPN

• Home Health Agency in Ludington, MI
• Providers in Ludington, MI by specialty
• Home Health Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.