PENNOCK HOSPITAL BOARD OF TRUSTEES (NPI# 1104291202) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104291202 |
| Entity Type | Organization |
| Organization Name | PENNOCK HOSPITAL BOARD OF TRUSTEES |
| Practice Address |
2776 S State Rd Ionia MI 48846-8472 |
| Mailing Address |
100 Michigan St Ne Mc 845 Grand Rapids MI 49503-2560 |
| Practice Telephone | 6164866790 |
| Mailing Telephone | 6164866790 |
| Enumeration Date | 2015-12-01 |
| Last Update Date | 2016-01-25 |
| Authorized Official Name | CONNIE DOWNS (VP FINANCE) |
| Authorized Official Telephone | 2699483122 |
| Is Organization Subpart | Y |
| Parent Organization Name | PENNOCK HOSPITAL BOARD OF TRUSTEES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780046227 | Pennock Hospital Board of Trustees | Obstetrics & Gynecology | 11275 Sprague Rd, Delton, MI 49046-8493 | 2016-03-23 |
| 1124488812 | Pennock Hospital Board of Trustees | Surgery | 1005 W Green St, Hastings, MI 49058-1712 | 2016-02-24 |
| 1508225632 | Pennock Hospital Board of Trustees | Family Medicine | 1108 W State St, Hastings, MI 49058-9711 | 2016-02-17 |
| 1053635359 | Pennock Hospital Board of Trustees | General Acute Care Hospital | 4294 Laurel Dr, Lake Odessa, MI 48849-8430 | 2010-03-16 |
| 1841488178 | Pennock Hospital Board of Trustees | Emergency Medicine | 1009 W Green Street, Hastings, MI 49058-1710 | 2007-10-11 |
| Street Address |
2776 S STATE RD |
| City | IONIA |
| State | MI |
| Zip Code | 48846-8472 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043311772 | Donald J Gingerich | Family Medicine | 2776 S State Rd, Ionia, MI 48846-8472 | 2006-09-26 |
| 1316402779 | Nicole Marie Baker | Physician Assistant | 2776 S State Rd, Ionia, MI 48846-8472 | 2019-02-08 |
| 1245751908 | Alifa Ashley Mohamed | Family Medicine | 2776 S State Rd, Ionia, MI 48846-8472 | 2017-07-03 |
| 1336688639 | Sara Casey | Nurse Practitioner | 2776 S State Rd, Ionia, MI 48846-8472 | 2017-02-20 |
| 1710422696 | Blake Geschke | Physician Assistant | 2776 S State Rd, Ionia, MI 48846-8472 | 2016-12-30 |
| 1942757869 | Anthony Lee Sands | Physician Assistant | 2776 S State Rd, Ionia, MI 48846-8472 | 2016-09-08 |
| 1477940773 | Pennock Hospital | Clinic/Center | 2776 S State Rd, Ionia, MI 48846-8472 | 2015-04-24 |
| 1518355437 | Steven Robert Mogridge | Physician Assistant | 2776 S State Rd, Ionia, MI 48846-8472 | 2014-12-30 |
| 1689076317 | Kayley Bruinsma | Nurse Practitioner | 2776 S State Rd, Ionia, MI 48846-8472 | 2014-09-25 |
| 1942640834 | Richard Mason | Family Medicine | 2776 S State Rd, Ionia, MI 48846-8472 | 2013-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346728003 | William Thomas Franklin-cromwell | Social Worker | 4832 E Bluewater Hwy, Ionia, MI 48846 | 2018-08-03 |
| 1992244974 | Jane Sielski | Nurse Practitioner | 2776 S State Rd # M66, Ionia, MI 48846 | 2017-02-23 |
| 1184074676 | Rachael Greenman | Technician, Other | 321 Colby St, Ionia, MI 48846 | 2016-06-15 |
| 1093059388 | Alicia Lynn Ballard | Orthopaedic Surgery | 537 W. Main St Suite 102, Ionia, MI 48846 | 2012-11-27 |
| 1538301643 | Places LLC | Registered Nurse | 910 E Lincoln, Ionia, MI 48846 | 2009-04-03 |
| 1285856419 | Goodwill Optical Inc | Optometrist | 153 W Sprague Rd, Ionia, MI 48846 | 2007-05-03 |
| 1033271143 | Sparrow Ionia Hospital | Family Medicine | 550 East Washington Street, Ionia, MI 48846 | 2006-12-14 |
| 1841364833 | Sandra Irene Herron | Physical Therapist | 3751 S State Rd, Ionia, MI 48846 | 2006-11-20 |
| 1407920531 | Brooke Lynne Cheney | Physical Therapist | 3751 S State Road, Ionia, MI 48846 | 2006-11-20 |
| 1356415483 | Grand River Physical Therapy Specialists PC | Physical Therapist | 3751 South State Rd, Ionia, MI 48846 | 2006-11-20 |
| Find all providers in zip 48846 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| 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. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033271143 | Sparrow Ionia Hospital | Family Medicine | 550 East Washington Street, Ionia, MI 48846 | 2006-12-14 |
| 1043311772 | Donald J Gingerich | Family Medicine | 2776 S State Rd, Ionia, MI 48846-8472 | 2006-09-26 |
| 1831144179 | Christopher M Ruthruff | Family Medicine | 550 E Washington St, Ste 205, Ionia, MI 48846-2202 | 2006-05-24 |
| 1851341499 | Michael Kevin Estes | Family Medicine | 479 Lafayette St, Ionia, MI 48846-1834 | 2006-05-12 |
| 1124018536 | Sheila Marie Gendich | Family Medicine | 910 E Lincoln Ave, Ionia, MI 48846-1393 | 2005-10-26 |
| 1598751968 | John F. Hildebrandt | Family Medicine | 330 Lovell St, Ionia, MI 48846-9706 | 2005-09-21 |
| 1528673290 | Adoc LLC | Family Medicine | 910 E Lincoln Ave, Ionia, MI 48846-1393 | 2020-09-10 |
| 1245751908 | Alifa Ashley Mohamed | Family Medicine | 2776 S State Rd, Ionia, MI 48846-8472 | 2017-07-03 |
| 1942640834 | Richard Mason | Family Medicine | 2776 S State Rd, Ionia, MI 48846-8472 | 2013-06-25 |
| 1922267939 | John Cegielski Jr. | Family Medicine | 550 E Washington St, Family Health Center Bldg., Ionia, MI 48846-2202 | 2008-06-04 |
| Find all providers in IONIA | ||||
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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.