PENNOCK HOSPITAL BOARD OF TRUSTEES (NPI# 1508225632) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508225632 |
| Entity Type | Organization |
| Organization Name | PENNOCK HOSPITAL BOARD OF TRUSTEES |
| Practice Address |
1108 W State St Hastings MI 49058-9711 |
| Mailing Address |
100 Michigan St Ne Mc 845 Grand Rapids MI 49503-2560 |
| Practice Telephone | 2699458080 |
| Enumeration Date | 2016-02-17 |
| Last Update Date | 2016-02-17 |
| Authorized Official Name | ROBERT DAVIS (VP PHYSICIAN NETWORK) |
| Authorized Official Telephone | 2699451220 |
| Is Organization Subpart | Y |
| Parent Organization Name | PENNOCK HOSPITAL BOARD OF TRUSTEES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| 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 |
| 1104291202 | Pennock Hospital Board of Trustees | Internal Medicine | 2776 S State Rd, Ionia, MI 48846-8472 | 2015-12-01 |
| 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 |
1108 W STATE ST |
| City | HASTINGS |
| State | MI |
| Zip Code | 49058-9711 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992709562 | Scott B Brasseur | Internal Medicine | 1108 W State St, Suite 3, Hastings, MI 49058-9711 | 2005-06-10 |
| 1780104182 | Renee Birchmeier | Nurse Practitioner | 1108 W State St, Hastings, MI 49058-9711 | 2017-06-27 |
| 1023557634 | Alia Anthony | Nurse Practitioner | 1108 W State St, Suite 3, Hastings, MI 49058-9711 | 2017-02-15 |
| 1396190138 | Pennock Hospital | Clinic/Center | 1108 W State St, Suite 3, Hastings, MI 49058-9711 | 2016-04-29 |
| 1093066086 | Tiffany R Jackson | Nurse Practitioner | 1108 W State St, Suite 3, Hastings, MI 49058-9711 | 2012-10-01 |
| 1932490885 | Pennock State Street Center | Nurse Practitioner | 1108 W State St, Hastings, MI 49058-9711 | 2011-04-27 |
| 1659526481 | Womens Health First PC | Obstetrics & Gynecology | 1108 W State St, Suite 3, Hastings, MI 49058-9711 | 2008-11-20 |
| 1649299223 | Laura J Kota | Obstetrics & Gynecology | 1108 W State St, Suite 3, Hastings, MI 49058-9711 | 2006-07-18 |
| 1346284759 | Robert A Valice | Obstetrics & Gynecology | 1108 W State St, Suite 3, Hastings, MI 49058-9711 | 2006-06-15 |
| 1275589913 | Leon Vanderlaan | Physician Assistant | 1108 W State St, Hastings, MI 49058-9711 | 2006-05-25 |
| 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 | 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 |
|---|---|---|---|---|
| 1427516160 | Thomas M Hoffman, M.d. | Family Medicine | 225 S M 37 Hwy Ste 2, Hastings, MI 49058-9676 | 2019-03-12 |
| 1770055469 | Rebecca Jean Barczak | Family Medicine | 268 Coleman Street, Hastings, PA 16646-0500 | 2018-12-19 |
| 1104313436 | Diana Catherine Diemer | Family Medicine | 1005 W Green St Ste 304, Hastings, MI 49058-1725 | 2018-04-23 |
| 1417385493 | James Edgar Atkinson | Family Medicine | 2425 Kathryn Drive, Hastings, MI 49058 | 2013-10-29 |
| 1992033757 | James Robert Spindler | Family Medicine | 1935 N Broadway St, Hastings, MI 49058-1086 | 2009-12-05 |
| 1639356389 | Raymond J Mikelionis | Family Medicine | 201 W. Lattin Street, Hastings, FL 32145-4111 | 2008-01-24 |
| 1982802450 | Suzanne Minarick Greenquist | Family Medicine | 960 E 54th St, Hastings, NE 68901-1959 | 2007-07-06 |
| 1790994911 | Glicerio V Ignacio Jr. | Family Medicine | 187 Laurel Drive, Hastings, PA 16646 | 2007-05-22 |
| 1790871093 | Stacia Gilde Marie Lagarde | Family Medicine | 200 S Boltwood St, Hastings, MI 49058-1926 | 2006-10-05 |
| 1457396921 | Zia Ahmed Siddiqui | Family Medicine | 1427 Riverbluff Dr, Hastings, MN 55033-6501 | 2006-06-18 |
| Find all providers in HASTINGS | ||||
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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.