PENNOCK HOSPITAL (NPI# 1023340981) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023340981 |
| Entity Type | Organization |
| Organization Name | PENNOCK HOSPITAL |
| Practice Address |
1005 W Green St Hastings MI 49058-1712 |
| Mailing Address |
100 Michigan St Ne Mc 845 Grand Rapids MI 49503-2560 |
| Practice Telephone | 2699458080 |
| Enumeration Date | 2010-02-03 |
| Last Update Date | 2016-04-22 |
| Authorized Official Name | DEIDRE WELLER (CONTROLLER) |
| Authorized Official Telephone | 2699451212 |
| Is Organization Subpart | Y |
| Parent Organization Name | PENNOCK HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023001146 | Pennock Hospital | General Acute Care Hospital | 1009 W Green St, Hastings, MI 49058-1710 | 2005-08-24 |
| 1932695525 | Pennock Hospital | General Acute Care Hospital | 1009 W Green St, Hastings, MI 49058-1710 | 2018-07-06 |
| 1013453760 | Pennock Hospital | Clinic/Center | 490 Edward St, Middleville, MI 49333-9131 | 2017-01-18 |
| 1689127847 | Pennock Hospital | Family Medicine | 490 Edward St, Middleville, MI 49333-9131 | 2016-07-24 |
| 1326495326 | Pennock Hospital | Nurse Practitioner | 9090 S Rodgers Ct Se, Caledonia, MI 49316-8052 | 2016-05-19 |
| 1205281045 | Pennock Hospital | Nurse Practitioner | 12851 W M 179 Hwy, Wayland, MI 49348-9318 | 2016-04-29 |
| 1396190138 | Pennock Hospital | Clinic/Center | 1108 W State St, Suite 3, Hastings, MI 49058-9711 | 2016-04-29 |
| 1841644184 | Pennock Hospital | Clinic/Center | 1005 W Green St, Suite 301, Hastings, MI 49058-1712 | 2016-04-22 |
| 1801250907 | Pennock Hospital | Clinic/Center | 12851 W M 179 Hwy, Wayland, MI 49348-9318 | 2016-04-05 |
| 1275999286 | Pennock Hospital | Family Medicine | 4294 Laurel Dr, Lake Odessa, MI 48849-8430 | 2016-01-06 |
| Street Address |
1005 W GREEN ST |
| City | HASTINGS |
| State | MI |
| Zip Code | 49058-1712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144224700 | Steven George Wildern | Specialist | 1005 W Green St, Rm 301, Hastings, MI 49058-1729 | 2005-06-10 |
| 1235676651 | Tami Pettenger | Registered Nurse | 1005 W Green St, Ste 300, Hastings, MI 49058-1712 | 2017-01-24 |
| 1841644184 | Pennock Hospital | Clinic/Center | 1005 W Green St, Suite 301, Hastings, MI 49058-1712 | 2016-04-22 |
| 1124488812 | Pennock Hospital Board of Trustees | Surgery | 1005 W Green St, Hastings, MI 49058-1712 | 2016-02-24 |
| 1821497223 | Diane Hart | Registered Nurse | 1005 W Green St, Hastings, MI 49058-1712 | 2014-08-21 |
| 1215351317 | Roxanne R Gaiski | Advanced Practice Midwife | 1005 W Green St, Ste 301, Hastings, MI 49058-1712 | 2014-02-10 |
| 1437594991 | West Michigan Heart | Internal Medicine | 1005 W Green St, Hastings, MI 49058-1712 | 2013-05-09 |
| 1649566076 | Jimmie Daniel Woodall | Obstetrics & Gynecology | 1005 W Green St, Ste 301, Hastings, MI 49058-1712 | 2011-06-23 |
| 1215221353 | Pennock Hospital | Internal Medicine | 1005 W Green St, Hastings, MI 49058-1712 | 2011-06-07 |
| 1265732366 | Spectrum Health Primary Care Partners | Internal Medicine | 1005 W Green St, Hastings, MI 49058-1712 | 2010-10-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760941942 | Valerie Joy Gardiner | Licensed Practical Nurse | 1359 Avon St, Hastings, MI 49058 | 2019-03-18 |
| 1538528633 | Forefront Dermatology, S.c. | Dermatology | 1761 W M 43 Hwy Ste 2, Hastings, MI 49058 | 2016-02-17 |
| 1376936807 | Angels On The Go | Home Health | 959 1/2 Williams Dr., Hastings, MI 49058 | 2015-03-09 |
| 1134524226 | Forefront Dermatology, S.c. | Dermatology | 1005 W. Green Street, Suite 200, Hastings, MI 49058 | 2014-10-31 |
| 1417385493 | James Edgar Atkinson | Family Medicine | 2425 Kathryn Drive, Hastings, MI 49058 | 2013-10-29 |
| 1689006918 | Bosley Pharmacy No. 2 Inc | Pharmacy | 118 S. Jefferson St., Hastings, MI 49058 | 2013-08-09 |
| 1740539345 | Kristen Burpee | Physical Therapist | 535 W. Woodlawn, Hastings, MI 49058 | 2012-08-29 |
| 1932344819 | Timothy York Adams | Counselor | 1100 Willitts Rd, Hastings, MI 49058 | 2008-12-08 |
| 1689820169 | Jennifer L Nobert | Physician Assistant | 1005 W Green St Ste 202, Hastings Internal Medicine, Hastings, MI 49058 | 2008-08-15 |
| 1457578072 | Sue Ellen Eastman | Social Worker | 350 Meadow Run Drive, #3, Hastings, MI 49058 | 2007-04-18 |
| Find all providers in zip 49058 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417060294 | Oscar Degoa | Obstetrics & Gynecology | 1108 W State Street, Suite 3, Hastings, MI 49058-1709 | 2006-08-16 |
| 1164876942 | Gita Byraiah | Obstetrics & Gynecology | 1285 Nininger Rd, Hastings, MN 55033-1086 | 2016-04-19 |
| 1649566076 | Jimmie Daniel Woodall | Obstetrics & Gynecology | 1005 W Green St, Ste 301, Hastings, MI 49058-1712 | 2011-06-23 |
| 1659526481 | Womens Health First PC | Obstetrics & Gynecology | 1108 W State St, Suite 3, Hastings, MI 49058-9711 | 2008-11-20 |
| 1164689667 | Jennifer Ann Slostad | Obstetrics & Gynecology | 1210 1st St W, Hastings, MN 55033-1147 | 2008-05-21 |
| 1053503680 | Angela Carol Faulkner | Obstetrics & Gynecology | 1210 1st St W, Hastings, MN 55033-1147 | 2007-08-17 |
| 1598963027 | Tyler J Adam | Obstetrics & Gynecology | 2115 N Kansas Ave, Suite 204, Hastings, NE 68901-2698 | 2007-07-05 |
| 1306966700 | Hastings Gynecology & Obstetrics, P.C. | Obstetrics & Gynecology | 1005 W Green St, Suite 201, Hastings, MI 49058-1712 | 2007-03-30 |
| 1629123435 | Laura M Doherty | Obstetrics & Gynecology | 1005 W Green St, Suite 301, Hastings, MI 49058-1712 | 2007-01-24 |
| 1649299223 | Laura J Kota | Obstetrics & Gynecology | 1108 W State St, Suite 3, Hastings, MI 49058-9711 | 2006-07-18 |
| Find all providers in HASTINGS | ||||
Please comment or provide details below to improve the information on PENNOCK HOSPITAL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.