NPIMap

Bronson Lakeview Hospital

Organization Active NPI Rural Health Clinic/Center · Decatur, MI

NPI 1376767285 · NPPES record last updated Nov 27, 2023

Key facts

NPI
1376767285
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
BRONSON LAKEVIEW HOSPITAL
Practice address
319 W Delaware St
Decatur, MI 49045-1106
Phone
(269) 423-7028
Fax
(269) 423-8282
NPI assigned
Apr 12, 2007
Organization subpart
Yes
Parent organization (as reported)
BRONSON LAKEVIEW HOSPITAL

Authorized official

Name
Rebecca East
Title
SVP, Cfo
Phone
(269) 341-6000

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 2

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

Facilities connected through Provider of Services related, parent or unit certification numbers.

Facilities with the same owner 11

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners 72

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 72

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0377660Bronson Lakeview Family Care Decatur
319 Delaware Street, Decatur, MI 49045		Provider-performed microscopyJul 10, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI

Rural health clinic certification: CCN 238546

Legal name
BRONSON LAKEVIEW HOSPITAL
Doing business as
BRONSON LAKEVIEW FAMILY CARE-DECATUR
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 5, 1997
Last certification
Aug 15, 2025
Ownership / control type
2B
Most recent change of ownership
Apr 1, 2007 (1 total)
Organization structure
Corporation · Non-profit
Incorporated
Oct 25, 2007 in MI
Enrollment address
319 W Delaware St
Decatur, MI 49045-1106
Related CCNs
231332

All disclosed owners & managing parties 31

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Bill Harold Manns
Individual 		Corporate Officer
President & Ceo		 Jan 1, 2020
William B Workman
Individual 		Corporate Director
Vice Chief of Staff		 Jul 1, 2022
Mike Way
Individual 		Corporate Officer
SVP		 Jan 1, 1986
Rebecca East
Individual 		Corporate Officer
SVP, Cfo		 Feb 1, 2015
W-2 Managing Employee
SVP, Cfo		 Feb 1, 2015
Lajune Montgomery-Tabron
Individual 		Corporate Director
Board Member		 Jul 1, 2011
Michael F Odar
Individual 		Corporate Director
Director		 Jul 1, 2016
Steven J Lins
Individual 		Corporate Director
Board Member		 Jul 1, 2011
Barbara L James
Individual 		Corporate Director Jan 1, 2008
Erick Stewart
Individual 		Corporate Director
Board Member		 Nov 1, 2022
Susan Reinoehl
Individual 		Corporate Officer
SVP, Cso		 Jan 1, 1995
Ashley Rhoderick
Individual 		W-2 Managing Employee Apr 24, 2020
James L Liggins
Individual 		Corporate Director
Director		 Jan 1, 2016
Cheryl Johnson
Individual 		Corporate Officer
SVP, Cpo		 Jan 1, 2021
Leigh Ann Colegrove
Individual 		W-2 Managing Employee
System Credentialing Coordinator		 Oct 11, 2021
Lynn Chen-Zhang
Individual 		Corporate Director Nov 1, 2022
William D Johnston
Individual 		Corporate Director
Board Member		 Jul 1, 2011
Jorge Gonzalez
Individual 		Corporate Director
Director		 Jan 1, 2018
Namita Sharma
Individual 		Corporate Director
Board		 Nov 1, 2022
Richard J Allen
Individual 		Corporate Director
Director		 Jan 1, 2017
Bronson Health Care Group Inc
Organization · Kalamazoo, MI
Non-profit 		5% Or Greater Direct Ownership Interest Jul 1, 2008 100%
Operational/Managerial Control Jul 1, 2008 100%
Scott Larson
Individual 		Corporate Officer
SVP Cmo		 Jun 1, 2014
W-2 Managing Employee
SVP Cmo		 Jun 1, 2014
Mary Fink
Individual 		Corporate Director
Director		 Jan 1, 2017
Scott C Gibson
Individual 		Corporate Director Jun 1, 2008
Luther Marshall Washington
Individual 		Corporate Director
Board Member		 Nov 1, 2022
Mahesh C Karamchandani
Individual 		Corporate Director
Board Member		 Jul 1, 2011
Randall W. Eberts
Individual 		Corporate Director Jan 1, 2008
Brenda L Hunt
Individual 		Corporate Director
Board Member		 Jul 1, 2011
Donald R. Parfet
Individual 		Corporate Director Jan 1, 2008
James B Falahee
Individual 		Corporate Officer
SVP Legal & Legislative Affairs		 Jun 1, 2014
W-2 Managing Employee
SVP Legal & Legislative Affairs		 Jun 1, 2014
Neil Nyberg
Individual 		Corporate Director
Board Member		 Jul 1, 2011
Nelson Karre
Individual 		Corporate Director
Board Member		 Jul 1, 2011

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20080523000537 MI Part a Provider - Rural Health Clinic 9032008495 Practice locations: Decatur, MI

National Provider Directory

Tax ID family
Lake View Community Hos (3 organizations share this tax ID)
Part of
Lake View Community Hos

Locations

301 John St
#42
Kalamazoo, MI 49007

451 Health Pkwy
Ste G
Paw Paw, MI 49079
Phone (269) 668-3348

2600 W Centre Ave
Portage, MI 49024
Phone (269) 324-4141

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X
Rural Health Clinic/Center 261QR1300X Yes
Rural Acute Care Hospital 282NR1301X 80-0041 MI

Addresses

Primary practice location

319 W Delaware St
Decatur, MI 49045-1106

Mailing address

301 John St
Box 42
Kalamazoo, MI 49007-5295
Phone (269) 341-7806

Other names

  • Bronson Lakeview Family Care-Decatur Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct

Other providers in Decatur, MI

All providers in Decatur, MI · Rural Health Clinic/Center in Michigan

Sources for this page

Verify at the official NPI Registry.