OrganizationActive
St John Providence Eastwood Clinic
NPI 1558619510 · Clinic/Center · Detroit, MI
St John Providence Eastwood Clinic is a Clinic/Center organization in Detroit, MI (NPI 1558619510).
Provider details
- NPI number
- 1558619510
- Entity type
- Organization
- Primary specialty
- Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Donald Healy, Supervisor(313) 369-5508
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(79/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4777 E Outer Dr Ste 1105
Detroit, MI 48234-3241
Phone: (313) 369-5508
Street-level locationGet directions
Mailing address
4777 E Outer Dr Ste 1105
Detroit, MI 48234-3241
Registry dates
- Enumerated
- 2012-08-23
- Last updated
- 2012-08-23
Frequently asked questions
- What is St John Providence Eastwood Clinic's NPI number?
- St John Providence Eastwood Clinic's National Provider Identifier (NPI) is 1558619510, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is St John Providence Eastwood Clinic?
- St John Providence Eastwood Clinic is classified in the NPPES registry as Clinic/Center (Ambulatory Health Care Facilities).
- Where is St John Providence Eastwood Clinic located?
- St John Providence Eastwood Clinic's practice location on file with NPPES is 4777 E Outer Dr Ste 1105, Detroit, MI 48234-3241.
- What is St John Providence Eastwood Clinic's phone number?
- The practice phone number listed in the NPPES registry for St John Providence Eastwood Clinic is (313) 369-5508.
- Who is the authorized official for St John Providence Eastwood Clinic?
- The authorized official listed on St John Providence Eastwood Clinic's NPPES record is Donald Healy, Supervisor. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is St John Providence Eastwood Clinic's NPI active?
- Yes — St John Providence Eastwood Clinic's NPI (1558619510) is active in the NPPES registry as of the last update on 2012-08-23.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.