NPIMap

Organization Active NPI

St John Macomb-Oakland Hospital

  • Emergency Medical Services (Emergency Medicine) Physician
  • Warren, MI
National Provider Identifier
1902817620
Registry record updated Jun 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
Legal business name
ST JOHN MACOMB-OAKLAND HOSPITAL
Practice address
11800 E 12 Mile Rd
ER Department
Warren, MI 48093-3472
Phone
(586) 573-5028
NPI assigned
Aug 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2009

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

Authorized official

Name
William Darroch
Title
Manager, Finance
Phone
(586) 753-0305

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207PE0004X Primary

Addresses

Primary practice location

11800 E 12 Mile Rd
ER Department
Warren, MI 48093-3472

Mailing address

PO Box 673898
Detroit, MI 48267-3898
Phone (800) 531-5788

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243900800000",
    "number": "1902817620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 673898",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482673898",
            "telephone_number": "800-531-5788",
            "fax_number": "586-296-1143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 E 12 MILE RD",
            "address_2": "ER DEPARTMENT",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933472",
            "telephone_number": "586-573-5028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOHN MACOMB-OAKLAND HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2009-06-02",
        "status": "A",
        "authorized_official_last_name": "DARROCH",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "MANAGER, FINANCE",
        "authorized_official_telephone_number": "586-753-0305"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2009; 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.