NPIMap

Organization Active NPI

Memorial Medical Center of West Michigan

Doing business as Corewell Health Ludington Hospital Professional

  • Family Medicine Physician
  • Ludington, MI
National Provider Identifier
1144639360
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MEMORIAL MEDICAL CENTER OF WEST MICHIGAN
Doing business as
Corewell Health Ludington Hospital Professional
Practice address
5 N Atkinson Dr
Ludington, MI 49431-2918
Phone
(231) 845-3615
NPI assigned
Aug 13, 2014
Last updated
Aug 23, 2023By 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 Aug 23, 2023

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

Authorized official

Name
Ryan Catignani
Title
VP, Provider Services
Phone
(947) 522-0008

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Pediatric Adolescent Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080A0000X
Behavioral Neurology & Neuropsychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084B0040X

Addresses

Primary practice location

5 N Atkinson Dr
Ludington, MI 49431-2918

Mailing address

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

Other names 1

  • Corewell Health Ludington Hospital Professional Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071128000647 MI Part B Supplier - Clinic/Group Practice 3678543659 Receives reassigned benefits from 185 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Scottsville, MI; Ludington, MI; Grant, MI; Hesperia, MI; Hart, MI

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Spectrum Health

Practitioners & affiliated clinicians

Practitioners 151

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 151

NPI Registry JSON

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

{
    "created_epoch": "1407888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692748800000",
    "number": "1144639360",
    "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": "5 N ATKINSON DR",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494312918",
            "telephone_number": "231-845-3615"
        }
    ],
    "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": "2014-08-13",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A",
        "authorized_official_last_name": "CATIGNANI",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "VP, PROVIDER SERVICES",
        "authorized_official_telephone_number": "947-522-0008"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084B0040X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corewell Health Ludington Hospital Professional",
            "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 Aug 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.