NPIMap

Organization Active NPI

St Mary Mercy Physician Practices

  • Family Medicine Physician
  • Detroit, MI
National Provider Identifier
1801303086
Registry record updated May 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ST MARY MERCY PHYSICIAN PRACTICES
Practice address
5555 Conner St Ste 2691
Detroit, MI 48213-3812
Phone
(313) 692-8400
Fax
(313) 692-8431
NPI assigned
Jan 9, 2018
Last updated
May 4, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2026

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

Authorized official

Name
Ariana Grace Raymond
Title
Manager Provider Enrollment
Phone
(734) 343-1466

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

5555 Conner St Ste 2691
Detroit, MI 48213-3812

Mailing address

14555 Levan Rd Ste 310
Livonia, MI 48154-5085
Phone (734) 655-2989

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080425000614 MI Part B Supplier - Clinic/Group Practice 4587742804 Receives reassigned benefits from 63 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Livonia, MI; Pontiac, MI; Redford, MI; Waterford, MI; Westland, MI; Ypsilanti, MI; Ann Arbor, MI; Brighton, MI…

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
St Mary Mercy Practices4 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.

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1515456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777852800000",
    "number": "1801303086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14555 LEVAN RD STE 310",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481545085",
            "telephone_number": "734-655-2989",
            "fax_number": "734-655-8590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 CONNER ST STE 2691",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482133812",
            "telephone_number": "313-692-8400",
            "fax_number": "313-692-8431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARY MERCY PHYSICIAN PRACTICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-09",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A",
        "authorized_official_last_name": "RAYMOND",
        "authorized_official_first_name": "ARIANA",
        "authorized_official_middle_name": "GRACE",
        "authorized_official_title_or_position": "MANAGER PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "734-343-1466"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD Emdr",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 May 4, 2026; 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.