COREWELL HEALTH PENNOCK HOSPITAL FAMILY MEDICINE - MIDDLEVILLE – NPI #1013453760
Clinic/Center

COREWELL HEALTH PENNOCK HOSPITAL FAMILY MEDICINE - MIDDLEVILLE is an AHC clinic located in MIDDLEVILLE, MI. NPPES has assigned the NPI number 1013453760 to COREWELL HEALTH PENNOCK HOSPITAL FAMILY MEDICINE - MIDDLEVILLE on January 18, 2017. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “COREWELL HEALTH PENNOCK HOSPITAL FAMILY MEDICINE - MIDDLEVILLE” is a dba name, the actual legal business name for this organization is PENNOCK HOSPITAL. This provider is also associated with 2 additional names listed below. The primary taxonomy selected by this provider is 261QR1300X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Rural Health

The NPI profile was previously updated about 3 years ago on Aug 23, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for COREWELL HEALTH PENNOCK HOSPITAL FAMILY MEDICINE - MIDDLEVILLE below.

NPI Profile for
PENNOCK HOSPITAL

NPI Number
1013453760
Enumeration Date

(more than 9 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PENNOCK HOSPITAL
Doing Business As (dba): COREWELL HEALTH PENNOCK HOSPITAL FAMILY MEDICINE - MIDDLEVILLE
Other name(s)
All associated names:
Doing Business As (dba)
COREWELL HEALTH PENNOCK HOSPITAL FAMILY MEDICINE - MIDDLEVILLE
Doing Business As (dba)
Spectrum Health Pennock Family Medicine - Middleville
Primary location
490 EDWARD ST
MIDDLEVILLE, MI 49333-9131
Phone: (269) 795-4434 Fax: (269) 795-4271
Mailing address
100 MICHIGAN ST NE
MC 845
GRAND RAPIDS, MI 49503-2560
Phone: Fax:
Organization Subpart
Yes - COREWELL HEALTH PENNOCK HOSPITAL FAMILY MEDICINE - MIDDLEVILLE is subpart of another organization.
Authorized Official
JOHN SELLA
CONTROLLER
Phone: (616) 802-0206
Updated
Certification Date
Aug 23, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QR1300X
- Clinic/Center / Rural Health (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.