NPIMap

Organization Active NPI

Newaygo County General Hospital Association

Doing business as Corewell Health Gerber Hospital Obstetrics and Gynecology

  • Rural Health Clinic/Center
  • Fremont, MI
National Provider Identifier
1609009554
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
NEWAYGO COUNTY GENERAL HOSPITAL ASSOCIATION
Doing business as
Corewell Health Gerber Hospital Obstetrics and Gynecology
Spectrum Health Gerber Memorial Obstetrics and Gynecology
Practice address
212 S Sullivan Ave
Fremont, MI 49412-1548
Phone
(231) 924-1212
NPI assigned
Aug 26, 2009
Last updated
Aug 22, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
NEWAYGO COUNTY GENERAL HOSPITAL ASSOCIATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Authorized official

Name
Mr. John Sella
Title
Controller
Phone
(616) 802-0206

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

212 S Sullivan Ave
Fremont, MI 49412-1548

Mailing address

100 Michigan St NE
Mc845
Grand Rapids, MI 49503-2560

Other names 2

  • Corewell Health Gerber Hospital Obstetrics and Gynecology Doing business as
  • Spectrum Health Gerber Memorial Obstetrics and Gynecology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040423001232 MI Part B Supplier - Clinic/Group Practice 4880503051 Receives reassigned benefits from 205 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fremont, MI; Newaygo, MI; Hesperia, MI
O20101028001545 MI Part A Provider - Rural Health Clinic 4880503051 Practice locations: Fremont, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1609009554. Details of each certification follow.

Rural health clinic certification: CCN 238636

Legal name
NEWAYGO COUNTY GENERAL HOSPITAL ASSOCIATION
Doing business as
COREWELL HEALTH GERBER HOSPITAL OBSTETRICS AND GYNECOLOGY
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 1, 2011
Last certification
May 8, 2025
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
212 S Sullivan Ave
Fremont, MI 49412-1548
Related CCNs
231338

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

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Part of
Gerber Memorial Hospital

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Christina Freese Decker Individual Corporate Director Aug 18, 2020
OtherPresident & Ceo Oct 1, 2018
Talawnda L Bragg Individual Corporate Director Jan 1, 2022
Christopher B Port Individual Corporate Director Aug 18, 2020
Ronald M Hofman Individual Corporate Director Aug 18, 2020
Annica Euurand Waalkes Individual Corporate Director Aug 18, 2020
Teresa Arlene Treiber Individual W-2 Managing Employee Nov 1, 2025
Matthew E Cox Individual Corporate OfficerSVP Chief Finance Officer Feb 1, 2022
Operational/Managerial Control Feb 1, 2022
Mark Wilson Individual Corporate Director Aug 18, 2020
Corewell Health Organization, Grand Rapids, MI Corporation, Non-profit, Chain home office Operational/Managerial Control Sep 27, 2010
Johannie M Torres Individual Corporate Director Aug 18, 2020
Mary Doornbos Individual Corporate Director Aug 18, 2020
John Buckley Individual Corporate Director Aug 18, 2020
Sam R Watson Individual Corporate Director Aug 18, 2020
Bill P Pink Individual Corporate Director Aug 18, 2020
Simin Beg Individual Corporate Director Aug 18, 2020
Lynnette Ferrell-Robinson Individual Corporate Director Aug 18, 2020
Tamila Marlow Individual W-2 Managing Employee Nov 1, 2025

Owners & managing parties with NPI records 5

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

Facilities with the same owner 66

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

View all 66

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1251244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692662400000",
    "number": "1609009554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 S SULLIVAN AVE",
            "city": "FREMONT",
            "state": "MI",
            "postal_code": "494121548",
            "telephone_number": "231-924-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWAYGO COUNTY GENERAL HOSPITAL ASSOCIATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEWAYGO COUNTY GENERAL HOSPITAL ASSOCIATION",
        "enumeration_date": "2009-08-26",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A",
        "authorized_official_last_name": "SELLA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "616-802-0206",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corewell Health Gerber Hospital Obstetrics and Gynecology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Spectrum Health Gerber Memorial Obstetrics and Gynecology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fremont, MI

Sources for this page

Verify at the official NPI Registry.