NPIMap

Organization Active NPI

Pennock Hospital

Doing business as CHPNH TM Clinic Delton Kellog

  • Clinical Social Worker
  • Delton, MI
National Provider Identifier
1457088080
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
PENNOCK HOSPITAL
Doing business as
CHPNH TM Clinic Delton Kellog
Spectrum Health Pennock Hospital
Practice address
10425 Panther Pride
Delton, MI 49046-8825
Phone
(616) 775-7500
NPI assigned
Aug 3, 2022
Last updated
Sep 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Authorized official

Name
Ryan Catignani
Title
VP Finance
Phone
(947) 522-0008

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

10425 Panther Pride
Delton, MI 49046-8825

Mailing address

100 Michigan NE St Mc845
Grand Rapids, MI 49503-2560
Phone (616) 486-6790

Other names 2

  • CHPNH TM Clinic Delton Kellog Doing business as
  • Spectrum Health Pennock Hospital Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Donald Gingerich DO13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

10425 Panther Pride
Delton, MI 49046
Phone (269) 623-1520

NPI Registry JSON

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

{
    "created_epoch": "1659484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1457088080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN NE ST MC845",
            "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": "10425 PANTHER PRIDE",
            "city": "DELTON",
            "state": "MI",
            "postal_code": "490468825",
            "telephone_number": "616-775-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNOCK HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-03",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A",
        "authorized_official_last_name": "CATIGNANI",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "947-522-0008"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHPNH TM Clinic Delton Kellog",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Spectrum Health Pennock Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Delton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.