MEMORIAL MEDICAL CENTER OF WEST MICHIGAN (NPI# 1033518634) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033518634 |
| Entity Type | Organization |
| Organization Name | MEMORIAL MEDICAL CENTER OF WEST MICHIGAN |
| Practice Address |
500 N Hancock St Pentwater MI 49449-8935 |
| Mailing Address |
100 Michigan St Ne Mc 845 Grand Rapids MI 49503-2560 |
| Practice Telephone | 2318697051 |
| Mailing Telephone | 6164866790 |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2014-08-21 |
| Authorized Official Name | MARK VIPPERMAN (PRESIDENT) |
| Authorized Official Telephone | 2318452297 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEMORIAL MEDICAL CENTER OF WEST MICHIGAN |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689650160 | Memorial Medical Center of West Michigan | Home Health | 1n Atkinson Dr, Ludington, MI 49431-1906 | 2005-12-16 |
| 1972589489 | Memorial Medical Center of West Michigan | General Acute Care Hospital | 1 N Atkinson Dr, Ludington, MI 49431-1906 | 2005-12-16 |
| 1932662996 | Memorial Medical Center of West Michigan | Clinic/Center | 230 S Maple St, Grant, MI 49327-9006 | 2019-04-08 |
| 1730642794 | Memorial Medical Center of West Michigan | Clinic/Center | 78 N Division St, Hesperia, MI 49421-5100 | 2019-04-08 |
| 1093161820 | Memorial Medical Center of West Michigan | Clinic/Center | 250 Nelson Rd, Suite 1, Ludington, MI 49431-1993 | 2016-05-11 |
| 1215396205 | Memorial Medical Center of West Michigan | Clinic/Center | 7 N Atkinson Dr, Suite 113, Ludington, MI 49431-1953 | 2016-02-18 |
| 1982063210 | Memorial Medical Center of West Michigan | Clinic/Center | 7 Atkinson Dr, Ludington, MI 49431-1953 | 2016-02-15 |
| 1538528872 | Memorial Medical Center of West Michigan | Clinic/Center | 907 E Tinkham Ave, Ludington, MI 49431-1537 | 2016-02-15 |
| 1689050783 | Memorial Medical Center of West Michigan | Obstetrics & Gynecology | 250 Nelson Rd, Ludington, MI 49431-1993 | 2015-07-31 |
| 1174908388 | Memorial Medical Center of West Michigan | Obstetrics & Gynecology | 913 E Ludington Ave, Ludington, MI 49431-2437 | 2015-07-29 |
| Street Address |
500 N HANCOCK ST |
| City | PENTWATER |
| State | MI |
| Zip Code | 49449-8935 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518234301 | Renita Diehlman | Nurse Practitioner | 500 N Hancock St, Pentwater, MI 49449-8935 | 2011-11-21 |
| 1437568102 | Memorial Medical Center of West Michigan | Family Medicine | 500 N Hancock St, Pentwater, MI 49449-8935 | 2014-08-07 |
| 1497163216 | Memorial Medical Center of West Michigan | Clinic/Center | 500 N Hancock St, Pentwater, MI 49449-8935 | 2014-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518001387 | Douglas Michael Crossman | Dentist | 5994 Longbridge Rd, Pentwater, MI 49449 | 2007-02-16 |
| 1982792040 | Allan D Nelson | Family Medicine | 500 N Hancock, Pentwater, MI 49449 | 2006-10-11 |
| 1932317450 | Allan D. Nelson, M.d. | Clinic/Center | 500 Hancock St, Pentwater, MI 49449-0619 | 2007-05-18 |
| 1215095542 | Richard Scott Williams | Dentist | 540 N Hancock, Pentwater, MI 49449-0625 | 2006-12-06 |
| 1295072239 | Janice E. Brubaker | Doula | 5694 Longbridge Rd, Pentwater, MI 49449-8531 | 2013-01-10 |
| 1003274846 | Shannon Gayle Foster | Technician, Other | 2960 W Adams Rd, Pentwater, MI 49449-8579 | 2016-02-08 |
| 1043291446 | Jamey Melissa Gitchel Kistler | Speech-Language Pathologist | 7094 S Pere Marquette Hwy, Pentwater, MI 49449-9669 | 2005-11-11 |
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154599 | Kelly Phuong Doan | Nurse Practitioner | 27327 23 Mile Rd, Chesterfield, MI 48051-2045 | 2020-11-04 |
| 1275133217 | Maureen Mae Lewis | Nurse Practitioner | 2782 N Coleman Rd, Coleman, MI 48618-9721 | 2020-10-29 |
| 1073113460 | Taylor L Pichette | Nurse Practitioner | 758 Lucille Dr, Wolverine Lake, MI 48390-2327 | 2020-10-27 |
| 1295333938 | Amanda Covell | Nurse Practitioner | 624 Cherry St Se Apt 5, Grand Rapids, MI 49503-4778 | 2020-10-14 |
| 1689271314 | Nicole Conklin | Nurse Practitioner | 524 Doyle Rd, Laingsburg, MI 48848-9611 | 2020-10-06 |
| 1447857677 | Shelby Lynn Waibel | Nurse Practitioner | 560 W Mitchell St Ste 210, Petoskey, MI 49770-2276 | 2020-10-01 |
| 1497361638 | Amira Aljamal | Nurse Practitioner | 4601 Shenandoah Ave, Allen Park, MI 48101-3131 | 2020-09-22 |
| 1659987014 | Sean Thomas Kane | Nurse Practitioner | 13734 Parallel Ave, Alpena, MI 49707-7987 | 2020-09-21 |
| 1235743592 | Mojica, LLC | Nurse Practitioner | 4163 W Pointe Dr, Waterford, MI 48329-4648 | 2020-09-03 |
| 1942812094 | Meagan James | Nurse Practitioner | 407 E Huron River Dr, Belleville, MI 48111-2763 | 2020-08-20 |
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| 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.