NPIMap

Organization Active NPI

St John Hospital Corporation

  • Registered Dietitian
  • Detroit, MI
National Provider Identifier
1720111701
Registry record updated Oct 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
ST JOHN HOSPITAL CORPORATION
Practice address
22101 Moross Rd
Detroit, MI 48236-2148
Phone
(586) 228-4635
Fax
(586) 228-4520
NPI assigned
Mar 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2007

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

Authorized official

Name
Sandra Ellen Whitman
Title
Director
Phone
(586) 226-6823

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

22101 Moross Rd
Detroit, MI 48236-2148

Mailing address

43800 Garfield Rd
200
Clinton Township, MI 48038-1136
Phone (586) 228-4635

Other identifiers 1

IdentifierTypeStateIssuer
OQ262160OtherMIBCBSM GROUP

Other names 1

  • St John Registered Dietician group Other name

National Provider Directory

National Provider Directory
Tax ID family
St Johns Hospital Med74 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192147200000",
    "number": "1720111701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43800 GARFIELD RD",
            "address_2": "200",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381136",
            "telephone_number": "586-228-4635",
            "fax_number": "586-228-4520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22101 MOROSS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362148",
            "telephone_number": "586-228-4635",
            "fax_number": "586-228-4520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOHN HOSPITAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-10-12",
        "status": "A",
        "authorized_official_last_name": "WHITMAN",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "586-226-6823"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM GROUP",
            "identifier": "OQ262160",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St John Registered Dietician group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Oct 12, 2007; 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.