NPIMap

Organization Active NPI

Bronson South Haven Hospital

  • Rural Health Clinic/Center
  • South Haven, MI
National Provider Identifier
1407072754
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
1060000042 Issued in MI
Legal business name
BRONSON SOUTH HAVEN HOSPITAL
Practice address
955 S Bailey Ave Ste 200
South Haven, MI 49090-6743
Phone
(269) 637-5271
Fax
(269) 639-2818
NPI assigned
Apr 17, 2007
Last updated
Nov 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X 800020 MI
Rural Health Clinic/Center 261QR1300X 1060000042 MI Primary

Addresses

Primary practice location

955 S Bailey Ave Ste 200
South Haven, MI 49090-6743

Mailing address

601 John St
Box 42
Kalamazoo, MI 49007-5341
Phone (269) 341-6000

Electronic endpoints 1

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081205000549 MI Part A Provider - Rural Health Clinic 6204724834 Practice locations: South Haven, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407072754. Details of each certification follow.

Rural health clinic certification: CCN 233987

Legal name
BRONSON SOUTH HAVEN HOSPITAL
Doing business as
BRONSON SOUTH HAVEN HOSPITAL RHC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 1, 1994
Last certification
May 28, 2024
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
955 S Bailey Ave
Ste 200
South Haven, MI 49090-6743
Related CCNs
230085

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

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
South Haven Commun Hospital2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

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 Director May 11, 2020
William B Workman Individual Corporate Director Nov 1, 2022
Mike Way Individual Corporate DirectorSVP Jan 1, 1986
Martinson Kweku Arnan Individual Corporate Officer Jan 1, 2019
Rebecca East Individual Corporate OfficerCfo Jan 1, 2018
Michael F Odar Individual Corporate DirectorDirector Jan 1, 2016
Steven J Lins Individual Corporate DirectorDirector Jan 1, 2011
Erick Stewart Individual Corporate Director Nov 1, 2022
Katharine Hermsen Individual Corporate Director Jan 1, 2025
Susan Reinoehl Individual Corporate DirectorSVP, Cso Jan 1, 1995
Robert M Nicholson Individual Corporate Director Jul 1, 2024
James L Liggins Individual Corporate DirectorDirector Jan 1, 2016
Cheryl Johnson Individual Corporate OfficerSVP, Cpo Jan 1, 2021
Leigh Ann Colegrove Individual W-2 Managing EmployeeSystem Credentialing Coordinator Oct 11, 2021
Lynn Chen-Zhang Individual Corporate Director Nov 1, 2022
Jorge Gonzalez Individual Corporate DirectorDirector Jan 1, 2018
Namita Sharma Individual Corporate Director Nov 1, 2022
Richard J Allen Individual Corporate Director Jul 1, 1998
Kellie Hoffman Individual Corporate Director Jan 1, 2025
Genevieve Coleman Individual Corporate Director Jan 1, 2025
Bronson Health Care Group Inc Organization, Kalamazoo, MI Created for acquisition, Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2017 100%
Rachel Worgess Individual Corporate Director Jan 1, 2025
Scott C Gibson Individual Corporate DirectorDirector Jan 1, 2006
Luther Marshall Washington Individual Corporate Director Nov 1, 2022
Randall W. Eberts Individual Corporate DirectorVice Chair Jan 1, 1999
Grace Lubwama Individual Corporate Director Jan 1, 2025
Brenda L Hunt Individual Corporate DirectorDirector Jul 1, 2011
Donald R. Parfet Individual Corporate DirectorDirector Jan 1, 1986
James B Falahee Individual Corporate OfficerClo, SVP Jan 1, 1995
Neil Nyberg Individual Corporate OfficerSecretary Jan 1, 2011
Nelson Karre Individual Corporate OfficerChair Jan 1, 2011

Owners & managing parties with NPI records 6

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

Facilities with the same owner 11

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

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763596800000",
    "number": "1407072754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 JOHN ST",
            "address_2": "BOX 42",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075341",
            "telephone_number": "269-341-6000",
            "fax_number": "269-341-8913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 S BAILEY AVE STE 200",
            "city": "SOUTH HAVEN",
            "state": "MI",
            "postal_code": "490906743",
            "telephone_number": "269-637-5271",
            "fax_number": "269-639-2818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRONSON SOUTH HAVEN HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A",
        "authorized_official_last_name": "EAST",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SVP, CFO",
        "authorized_official_telephone_number": "269-341-6000",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "MI",
            "license": "800020",
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "MI",
            "license": "1060000042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in South Haven, MI

Sources for this page

Verify at the official NPI Registry.