NPIMap

Organization Active NPI

Memorial Medical Center of West Michigan

Doing business as Spectrum Health Ludington Hospital

  • Pediatrics Physician
  • Ludington, MI
National Provider Identifier
1053794685
Registry record updated Jul 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
MEMORIAL MEDICAL CENTER OF WEST MICHIGAN
Doing business as
Spectrum Health Ludington Hospital
Practice address
907 E Tinkham Ave
Ludington, MI 49431-1537
Phone
(231) 843-3477
NPI assigned
Jul 1, 2015
Last updated
Jul 1, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
MEMORIAL MEDICAL CENTER OF WEST MICHIGANAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 1, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kerri Nelson
Title
VP Finance
Phone
(231) 845-2251

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Primary
Pediatric Adolescent Medicine Physician 2080A0000X

Addresses

Primary practice location

907 E Tinkham Ave
Ludington, MI 49431-1537

Mailing address

100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560
Phone (616) 486-6790

Other names 1

  • Spectrum Health Ludington Hospital Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Spectrum Health20 organizations share this tax ID, including this one
Part of
Spectrum Health

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435708800000",
    "number": "1053794685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-486-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 E TINKHAM AVE",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494311537",
            "telephone_number": "231-843-3477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL MEDICAL CENTER OF WEST MICHIGAN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEMORIAL MEDICAL CENTER OF WEST MICHIGAN",
        "enumeration_date": "2015-07-01",
        "last_updated": "2015-07-01",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "KERRI",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "231-845-2251"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spectrum Health Ludington Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ludington, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.