ST JOSEPH MERCY HOSPITAL NPI 1114045960

NPI Information

NPI: 1114045960
Provider Name: ST JOSEPH MERCY HOSPITAL
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 23D0902941

Address:
111 N HURON ST
SUITE 203
YPSILANTI, MI
ZIP 48197
Phone: (734) 547-7977
Get Directions

ST JOSEPH MERCY HOSPITAL is a family medicine in Ypsilanti, MI. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. ST JOSEPH MERCY HOSPITAL NPI is 1114045960. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

111 N HURON ST
SUITE 203
YPSILANTI, MI
ZIP 48197-676
Phone: (734) 547-7977

The provider's authorized official is Michael P Gusho .
The authorized official title is Cfo Se Mi Region and has the following contact phone number (248) 858-6174.

The CLIA number assigned to this NPI record is 23D0902941 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 3/27/2007 and was last updated on 10/5/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License State	Primary
1	207VX0201X	Obstetrics & Gynecology	Gynecologic Oncology	MICHIGAN	No
2	208000000X	Pediatrics		MICHIGAN	No
3	363AM0700X	Physician Assistant	Medical		No
4	207V00000X	Obstetrics & Gynecology		MICHIGAN	No
5	207VG0400X	Obstetrics & Gynecology	Gynecology	MICHIGAN	No
6	207R00000X	Internal Medicine		MICHIGAN	No
7	207RH0003X	Internal Medicine	Hematology & Oncology		No
8	363L00000X	Nurse Practitioner			No
9	363LX0001X	Nurse Practitioner	Obstetrics & Gynecology		No
10	207Q00000X	Family Medicine		MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	500H111070	OTHER	MICHIGAN	BLUE SHIELD
2	0M94890	MEDICARE PIN	MICHIGAN
3	110H111320	OTHER	MICHIGAN	BS BCN HABI
4	0N53240	MEDICARE ID-TYPE UNSPECIFIED	MICHIGAN	HABI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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