NPIMap

Organization Active NPI

St John Hospital Corporation

  • Physician Assistant
  • Detroit, MI
National Provider Identifier
1811068760
Registry record updated Oct 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
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
Nov 13, 2006
Last updated
Oct 12, 2007By the provider in NPPES
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 E Whitman
Title
Director, Physician Billing Service
Phone
(248) 746-5822

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary
Medical Physician Assistant 363AM0700X NU
Surgical Physician Assistant 363AS0400X NU

Addresses

Primary practice location

22101 Moross Rd
Detroit, MI 48236-2148

Mailing address

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

Other names 1

  • SJH Physician Assistant Group Other name

National Provider Directory

National Provider Directory
Tax ID family
St Johh Hospital Corp74 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": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192147200000",
    "number": "1811068760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43800 GARFIELD RD",
            "address_2": "STE 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": "2006-11-13",
        "last_updated": "2007-10-12",
        "status": "A",
        "authorized_official_last_name": "WHITMAN",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR, PHYSICIAN BILLING SERVICE",
        "authorized_official_telephone_number": "248-746-5822"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SJH Physician Assistant 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.