St John Hospital and Medical Center

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

ST JOHN HOSPITAL AND MEDICAL CENTER

Practice address

26755 Ballard St
Harrison Township, MI 48045-2419

Phone

(583) 753-0011

NPI assigned

Mar 9, 2007

Last updated

Apr 22, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Christopher J Palazzolo

Title

V.P. - Finance

Phone

(313) 343-3558

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Henry Ford Health St. John Hospital

  • Certified Registered Nurse Anesthetist
  • Detroit, MI
  • NPI 1598896995

  O20040130000407

  Same enrollment

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271894400000",
    "number": "1740312685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28000 DEQUINDRE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480922468",
            "telephone_number": "586-753-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26755 BALLARD ST",
            "city": "HARRISON TOWNSHIP",
            "state": "MI",
            "postal_code": "480452419",
            "telephone_number": "583-753-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOHN HOSPITAL AND MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2010-04-22",
        "status": "A",
        "authorized_official_last_name": "PALAZZOLO",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "V.P. - FINANCE",
        "authorized_official_telephone_number": "313-343-3558",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM PIN",
            "identifier": "0E01105",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angel Marie Seguin, BSN, RN
• Senior Safe, LLC
• Gloria J Severini, PT
• Gina M Smith
• Speech Unbound
• St John North Shores Emergency Physicians, P. C.
• St. John Hospital and Medical Center (St. John North Shores Hospital)
• St. John North Shores Hospital
• Laura Starr, LMT
• The Blue House Company LLC (Therapeutic Pathways)

• Certified Registered Nurse Anesthetist in Harrison Township, MI
• Providers in Harrison Township, MI by specialty
• Certified Registered Nurse Anesthetist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.