HACKLEY COMMUNITY CARE CENTER INC (NPI# 1629505714) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629505714 |
| Entity Type | Organization |
| Organization Name | HACKLEY COMMUNITY CARE CENTER INC |
| Other Organization Name | HACKLEY COMMUNITY CARE CENTER INC |
| Practice Address |
2700 Baker St Fl 3 Muskegon MI 49444-2157 |
| Practice Telephone | (231) 737-1335 |
| Practice Fax Number | 2317370534 |
| Mailing Telephone | 2317371335 |
| Mailing Fax Number | 2317370534 |
| Enumeration Date | 2017-05-19 |
| Last Update Date | 2017-05-19 |
| Authorized Official Name | ANTOINETTE HILDWEIN (CMO) |
| Authorized Official Telephone | 2317371335 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1629066238 | 05 |
| Other Name | Type Code |
|---|---|
| Hackley Community Care Center Inc | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658244 | Hackley Community Care Center Inc | Clinic/Center | 3113 Pontaluna Rd Ste A, Fruitport, MI 49415-9600 | 2020-10-30 |
| 1760080972 | Hackley Community Care Center Inc | Clinic/Center | 1420 Madison St Ste A, Muskegon, MI 49442-5251 | 2020-10-12 |
| 1922613975 | Hackley Community Care Center Inc | Clinic/Center | 6245 Syers Rd Ste A, Holton, MI 49425-7557 | 2020-09-15 |
| 1598319915 | Hackley Community Care Center Inc | Clinic/Center | 2312 Denmark St, Muskegon, MI 49441-1479 | 2019-07-25 |
| 1619485398 | Hackley Community Care Center Inc | Family Medicine | 481 S Wolf Lake Rd Ste A, Muskegon, MI 49442-3033 | 2018-01-17 |
| 1962881862 | Hackley Community Care Center Inc | Counselor | 1150 Amity Ave, Muskegon, MI 49442-3713 | 2015-05-26 |
| 1881073781 | Hackley Community Care Center Inc | Counselor | 480 Bennett St, Muskegon, MI 49442-2133 | 2015-05-26 |
| 1699154591 | Hackley Community Care Center Inc | Counselor | 2441 Sanford St, Muskegon, MI 49444-1438 | 2015-05-26 |
| 1063891968 | Hackley Community Care Center Inc | Counselor | 125 Catherine Ave, Muskegon, MI 49442-3331 | 2015-05-26 |
| 1508245408 | Hackley Community Care Center Inc | Counselor | 80 W Southern Ave, Muskegon, MI 49441-2541 | 2015-05-26 |
| Street Address |
2700 BAKER ST FL 3 |
| City | MUSKEGON |
| State | MI |
| Zip Code | 49444-2157 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447251442 | Margaret E Rosina Wolter | Nurse Practitioner | 2700 Baker St Fl 3, Muskegon, MI 49444-2157 | 2005-08-02 |
| 1912506635 | Hackley Community Care Center Inc | Clinic/Center | 2700 Baker St Fl 3, Muskegon, MI 49444-2157 | 2020-10-23 |
| 1134734569 | James Robert Mason | Counselor | 2700 Baker St Fl 3, Muskegon, MI 49444-2157 | 2020-09-11 |
| 1194369033 | Jessica Morgan Ladd | Social Worker | 2700 Baker St Fl 3, Muskegon, MI 49444-2157 | 2019-11-04 |
| 1558834788 | James J Tuljus | Physician Assistant | 2700 Baker St Fl 3, Muskegon, MI 49444-2157 | 2019-01-10 |
| 1649707092 | Krista Mashak | Social Worker | 2700 Baker St Fl 3, Muskegon, MI 49444-2157 | 2017-05-16 |
| 1780123968 | Katie Polaski | Physician Assistant | 2700 Baker St Fl 3, Muskegon, MI 49444 | 2017-02-21 |
| 1619414984 | Ryan Thomas Busch | Physician Assistant | 2700 Baker St Fl 3, Muskegon, MI 49444-2157 | 2017-01-25 |
| 1538511621 | Sara Strait | Nurse Practitioner | 2700 Baker St Fl 3, Muskegon, MI 49444-2157 | 2016-07-13 |
| 1194175612 | Hackley Community Care Center Inc | Family Medicine | 2700 Baker St Fl 3, Muskegon, MI 49444-2157 | 2016-06-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073084349 | Cathy Forrest, Ma, LLP Plc | Psychologist | 255 Seminole Road, Suite-205, Muskegon, MI 49444 | 2018-12-16 |
| 1831687276 | Sarah J Weiden | Massage Therapist | 1040 E Sternberg Rd, Muskegon, MI 49444 | 2018-04-30 |
| 1184131500 | Hatem M Gelani Sr. | Dentist | 1725 E Sherman Blvd, Muskegon, MI 49444 | 2018-01-08 |
| 1497123673 | Rite Aid | Pharmacist | 2213 E Hile Road, Muskegon, MI 49444 | 2015-09-04 |
| 1689077075 | Rosa Carpenter-parker | Counselor | 445 East Sherman, Muskegon, MI 49444 | 2014-09-30 |
| 1417373036 | Smile Center Pllc | Dentist | 3500 Park Street, Smile Center Pllc, Muskegon, MI 49444 | 2014-03-06 |
| 1134460439 | Adam L Powell | Physical Medicine & Rehabilitation | 1675 E Mount Garfield Rd, Muskegon, MI 49444 | 2013-03-12 |
| 1972847135 | Kristen Haugh | Physical Therapist | 5251 Harvey St Ste 100, Norton Shores, MI 49444 | 2012-11-12 |
| 1912261694 | Brandon D Freel | Obstetrics & Gynecology | 6401 Prairie St Ste 2100, Norton Shores, MI 49444 | 2012-06-27 |
| 1437434487 | Amy Stegall | Pharmacist | 1171 E Sherman, Norton Shores, MI 49444 | 2011-10-20 |
| Find all providers in zip 49444 | ||||
| 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 |
|---|---|---|---|---|
| 1619485398 | Hackley Community Care Center Inc | Family Medicine | 481 S Wolf Lake Rd Ste A, Muskegon, MI 49442-3033 | 2018-01-17 |
| 1306083050 | Gregory Theophill Sobczak | Family Medicine | 1327 Meadowview Dr, Muskegon, MI 49441-7011 | 2009-01-17 |
| 1952482424 | David Streeter | Family Medicine | 1710 Grevel Ct, Muskegon, MI 49444-7729 | 2006-10-18 |
| 1780779298 | Erwin Leroy Grasman | Family Medicine | 420 Whitehall Rd, Muskegon, MI 49445 | 2006-10-03 |
| 1770687089 | Ruth A Walkotten | Family Medicine | 2947 Russell Rd, Muskegon, MI 49445 | 2006-09-08 |
| 1407870009 | Homebound Wellness Solutions, P.C. | Family Medicine | 5828 Jefferson Ave, Muskegon, MI 49442-1958 | 2006-07-27 |
| 1861426348 | Thomas Lee Watkins | Family Medicine | 855 Oakridge Rd., Muskegon, MI 49441-4023 | 2006-07-10 |
| 1952347262 | Fred R Rollins | Family Medicine | 1790 Oak Ave, Muskegon, MI 49442-2407 | 2006-06-22 |
| 1992749014 | Hpcn | Family Medicine | 6401 Prairie Street, Suite 2600, Muskegon, MI 49444 | 2006-06-16 |
| 1669411088 | Branden Bruhn | Family Medicine | 1864 Lakeshore Drive, Muskegon, MI 49441 | 2006-06-05 |
| Find all providers in MUSKEGON | ||||
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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.