PENNOCK HOSPITAL (NPI# 1629494133) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629494133 |
| Entity Type | Organization |
| Organization Name | PENNOCK HOSPITAL |
| Practice Address |
840 Cook Rd Hastings MI 49058-9616 |
| Mailing Address |
100 Michigan St Ne Mc 845 Grand Rapids MI 49503-2560 |
| Practice Telephone | 2699459520 |
| Enumeration Date | 2014-03-07 |
| 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 | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207X00000X | Orthopaedic Surgery | 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 |
840 COOK RD |
| City | HASTINGS |
| State | MI |
| Zip Code | 49058-9616 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144290172 | Bryan Scott Kamps | Orthopaedic Surgery | 840 Cook Rd, Hastings, MI 49058-9616 | 2006-01-24 |
| 1043851132 | Daniel Adam Blasch | Physician Assistant | 840 Cook Rd, Hastings, MI 49058-9616 | 2019-10-01 |
| 1568855336 | Pennock Hospital | Durable Medical Equipment & Medical Supplies | 840 Cook Rd, Hastings, MI 49058-9616 | 2015-03-18 |
| 1710387295 | Norman Davidson | Physician Assistant | 840 Cook Rd, Hastings, MI 49058-9616 | 2014-09-03 |
| 1598164725 | Collin Mario Ludmer | Physician Assistant | 840 Cook Rd, Hastings, MI 49058-9616 | 2014-08-13 |
| 1598183196 | Derek Paul Axibal | Orthopaedic Surgery | 840 Cook Rd, Hastings, MI 49058-9616 | 2014-04-01 |
| 1235457698 | Michael James Youn | Physical Therapist | 840 Cook Rd, Hastings, MI 49058-9616 | 2010-05-11 |
| 1811197593 | Hastings Orthopedic Clinic | Durable Medical Equipment & Medical Supplies | 840 Cook Rd, Hastings, MI 49058-9616 | 2007-07-20 |
| 1346373065 | Hastings Orthopedic Clinic PC | Orthopaedic Surgery | 840 Cook Rd, Hastings, MI 49058-9616 | 2007-03-13 |
| 1467480152 | Kenneth S Merriman II | Orthopaedic Surgery | 840 Cook Rd, Hastings, MI 49058-9616 | 2006-06-29 |
| 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 | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| 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 Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710928130 | Barry A Bohlen | Orthopaedic Surgery | 2207 Osborne Dr W, Suite 100, Hastings, NE 68901-9112 | 2006-06-09 |
| 1174591275 | Jerome J Perra | Orthopaedic Surgery | 1285 Nininger Rd, Suite 107, Hastings, MN 55033-1086 | 2006-03-14 |
| 1144290172 | Bryan Scott Kamps | Orthopaedic Surgery | 840 Cook Rd, Hastings, MI 49058-9616 | 2006-01-24 |
| 1598183196 | Derek Paul Axibal | Orthopaedic Surgery | 840 Cook Rd, Hastings, MI 49058-9616 | 2014-04-01 |
| 1932321924 | Travis B. Stoner | Orthopaedic Surgery | 2207 Osborne Dr W, Suite 100, Hastings, NE 68901-9112 | 2007-05-02 |
| 1346373065 | Hastings Orthopedic Clinic PC | Orthopaedic Surgery | 840 Cook Rd, Hastings, MI 49058-9616 | 2007-03-13 |
| 1528098340 | Brent Hood | Orthopaedic Surgery | 2207 Osborne Dr W, Suite #100, Hastings, NE 68901-9112 | 2006-07-04 |
| 1467480152 | Kenneth S Merriman II | Orthopaedic Surgery | 840 Cook Rd, Hastings, MI 49058-9616 | 2006-06-29 |
| 1376587824 | Gary L. Chingren | Orthopaedic Surgery | 2207 Osborne Dr W, Suite 100, Hastings, NE 68901-9112 | 2006-06-15 |
| 1003858473 | Hastings Orthopaedics & Sports Medicine Specialists PC | Orthopaedic Surgery | 2207 Osborne Dr W, Suite 100, Hastings, NE 68901-9112 | 2006-06-12 |
| 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.