St. Michael Nursing Center

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

834031 Issued in MI

Legal business name

ST. MICHAEL NURSING CENTER

Practice address

19175 Anglin St
Detroit, MI 48234-1407

Phone

(313) 892-3600

Fax

(313) 892-5624

NPI assigned

Sep 22, 2005

Last updated

Aug 22, 2020By 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

Mrs. Pamela A Johnson

Title

Administrator

Phone

(313) 892-3600

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952397226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19175 ANGLIN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482341407",
            "telephone_number": "313-892-3600",
            "fax_number": "313-892-5624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19175 ANGLIN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482341407",
            "telephone_number": "313-892-3600",
            "fax_number": "313-892-5624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MICHAEL NURSING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "313-892-3600",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MI",
            "license": "834031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3178479",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• St. John Hospital and Medical Center
• St. John Hospital and Medical Center
• St. John Hospital Corporation (St. John OB Clinic MSSP)
• St. John Providence Community Health
• St. Joseph Medical Center PC
• St. Patrick Senior Center, Inc
• St. Ruth's House of Hope LLC
• St. Vincent de Paul Detroit Dental
• John Charles Stabb, PAC
• Brad A Stach, PH.D.

• Skilled Nursing Facility in Detroit, MI
• Providers in Detroit, MI by specialty
• Skilled Nursing Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.