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ST JOHN HOSPITAL AND MEDICAL CENTER
NPI 1780854174
Family Medicine in Saint Clair Shores, MI

Active since March 03, 2008
24911 LITTLE MACK AVE, SUITE C, SAINT CLAIR SHORES, MI 48080(586) 447-9081 Get Directions Write a Review

NPPES record last updated: March 3, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About St John Hospital And Medical Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ST JOHN HOSPITAL AND MEDICAL CENTER (NPI 1780854174) is a healthcare organization registered as a family medicine in Saint Clair Shores, Michigan and active in the NPI registry since March 2008. The organization lists Kenneth Bollin, Chief Of The Department Of Fm, as its authorized official.

NPPES Registry Identity

NPI1780854174
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameST JOHN HOSPITAL AND MEDICAL CENTER
Location Address24911 LITTLE MACK AVE, SUITE CSaint Clair Shores, MI 48080-3200
Mailing Address21441 Sloan Dr, Apt # 102 BHarper Woods, MI 48225-2428
Phone(586) 447-9081
Organization SubpartNo
Authorized OfficialKenneth BollinChief Of The Department Of Fm · (586) 447-9081
Enumeration DateMarch 3, 2008
✔ NPI 1780854174 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MI · 4301088641
Definition
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.
24911 LITTLE MACK AVE, Saint Clair Shores, MI 48080
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PATRICIA WEST PHD, RN
Nurse Practitioner (Psychiatric/Mental Health)
24911 LITTLE MACK AVE, SUITE C
SAINT CLAIR SHORES, MI 48080
Macomb County (586) 447-9070
KENNETH W BOLLIN MD
Family Medicine
24911 LITTLE MACK AVE
SAINT CLAIR SHORES, MI 48080
Macomb County (586) 777-2050
MITCHELL BECKER
Family Medicine
24911 LITTLE MACK AVE
SAINT CLAIR SHORES, MI 48080
Macomb County (586) 777-2050
EILEEN MARGARET REICKERT MD
Family Medicine
24911 LITTLE MACK AVE
ST CLAIR SHORES, MI 48080
Macomb County (586) 777-2050
DR. TERRY KENNETH DELUCA M.D.
Family Medicine
24911 LITTLE MACK AVE
SAINT CLAIR SHORES, MI 48080
Macomb County (586) 777-2050
DR. RITA SALEEM JADDOU M.D.
Family Medicine
24911 LITTLE MACK AVE
SAINT CLAIR SHORES, MI 48080
Macomb County (586) 447-9064
ST. JOHN FAMILY CENTER
Clinic/Center
24911 LITTLE MACK AVE, SUITE C
SAINT CLAIR SHORES, MI 48080
Macomb County (586) 753-0011
SAMINEH MIRHEYDARI MD
Family Medicine
24911 LITTLE MACK AVE
SAINT CLAIR SHORES, MI 48080
Macomb County (586) 777-2050

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is St John Hospital And Medical Center's NPI number?

The NPI number for St John Hospital And Medical Center is 1780854174. It was assigned to this organization in the NPPES registry on March 3, 2008.

Where is St John Hospital And Medical Center located?

St John Hospital And Medical Center is located at 24911 Little Mack Ave Suite C, Saint Clair Shores, MI 48080. The listed phone number is (586) 447-9081.

What is St John Hospital And Medical Center's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for St John Hospital And Medical Center was last updated on March 3, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.