NPIMap

Organization Active NPI

Pennock Hospital Board of Trustees

  • Surgery Physician
  • Hastings, MI
National Provider Identifier
1124488812
Registry record updated Feb 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
PENNOCK HOSPITAL BOARD OF TRUSTEES
Practice address
1005 W Green St
Hastings, MI 49058-1712
Phone
(269) 948-3632
NPI assigned
Feb 24, 2016
Last updated
Feb 24, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
PENNOCK HOSPITAL BOARD OF TRUSTEESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 24, 2016

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

Authorized official

Name
Connie Downs
Title
Controller-Finance
Phone
(269) 948-3122

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

1005 W Green St
Hastings, MI 49058-1712

Mailing address

100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560

National Provider Directory

National Provider Directory
Tax ID family
Pennock Hospital Borad13 organizations share this tax ID, including this one
Part of
Pennock Hospital Borad

Other organizations with this tax ID 12

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

NPI Registry JSON

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

{
    "created_epoch": "1456272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456272000000",
    "number": "1124488812",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 W GREEN ST",
            "city": "HASTINGS",
            "state": "MI",
            "postal_code": "490581712",
            "telephone_number": "269-948-3632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNOCK HOSPITAL BOARD OF TRUSTEES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PENNOCK HOSPITAL BOARD OF TRUSTEES",
        "enumeration_date": "2016-02-24",
        "last_updated": "2016-02-24",
        "status": "A",
        "authorized_official_last_name": "DOWNS",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_title_or_position": "CONTROLLER-FINANCE",
        "authorized_official_telephone_number": "269-948-3122"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hastings, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2016; 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.