NPIMap

Organization Active NPI

Pennock Hospital Board of Trustees

  • Family Medicine Physician
  • Hastings, MI
National Provider Identifier
1508225632
Registry record updated Feb 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PENNOCK HOSPITAL BOARD OF TRUSTEES
Practice address
1108 W State St
Hastings, MI 49058-9711
Phone
(269) 945-8080
NPI assigned
Feb 17, 2016
Last updated
Feb 17, 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 17, 2016

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

Authorized official

Name
Robert Davis
Title
VP Physician Network
Phone
(269) 945-1220

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1108 W State St
Hastings, MI 49058-9711

Mailing address

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

National Provider Directory

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

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": "1455667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455667200000",
    "number": "1508225632",
    "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": "1108 W STATE ST",
            "city": "HASTINGS",
            "state": "MI",
            "postal_code": "490589711",
            "telephone_number": "269-945-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNOCK HOSPITAL BOARD OF TRUSTEES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PENNOCK HOSPITAL BOARD OF TRUSTEES",
        "enumeration_date": "2016-02-17",
        "last_updated": "2016-02-17",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "VP PHYSICIAN NETWORK",
        "authorized_official_telephone_number": "269-945-1220"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "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 17, 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.