OrganizationActive
St John Providence Health System
NPI 1922063213 · Internal Medicine Physician · Southfield, MI
Provider details
- NPI number
- 1922063213
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Kimberly Cebalt, Director(313) 874-6764
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Diabetes Educator Registered Nurse163WD0400X
Nursing Service Providers
- Adult Health Nurse Practitioner363LA2200X
Physician Assistants & Advanced Practice Nursing Providers
- Nursing Care Agency251J00000X
Agencies
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 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
16001 W 9 Mile Rd
Southfield, MI 48075-4818
Phone: (248) 849-3000
Fax: (248) 849-2244
Street-level locationGet directions
Mailing address
3168 Solutions Center Box 773168
Chicago, IL 60677-0001
Other names (DBA / former)
- Doing business as
- Henry Ford Providence Hospital
- Other name
- Ph Internal Medicine/Providence Hospital and Medical Centers Inc
Registry dates
- Enumerated
- 2006-04-19
- Last updated
- 2026-02-16
- Certified
- 2026-02-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.