Newaygo County General Hospital Association
Organization Active NPI Rural Health Clinic/Center · Fremont, MI
NPI 1609009554 · NPPES record last updated Aug 22, 2023
Key facts
- NPI
- 1609009554
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- NEWAYGO COUNTY GENERAL HOSPITAL ASSOCIATION
- Practice address
- 212 S Sullivan Ave
Fremont, MI 49412-1548 - Phone
- (231) 924-1212
- NPI assigned
- Aug 26, 2009
- Organization subpart
- Yes
- Parent organization (as reported)
- NEWAYGO COUNTY GENERAL HOSPITAL ASSOCIATION
Authorized official
- Name
- Mr. John Sella
- Title
- Controller
- Phone
- (616) 802-0206
Owners & managing parties with NPI records 5
-
Simin Beg, MD
-
Talawnda L Bragg, MD
-
Annica E Waalkes, MD
Other NPIs on the same Medicare enrollment 6
Other NPIs with the same Medicare PAC ID 5
Related certifications (CCN) 1
Facilities with the same owner 66
Practitioners 67
-
Jeremy James Kuiper, M.D.
-
Eric R Weaver, MD
-
Wissam Mohamad Abdallah, M.D.
-
Asad Ahrar, MD
-
Amy Jo Arends, NP-C
-
Bret Gregory Autrey, D.O.
-
Paige Kristine Barber, PA-C
-
Melissa S Bayne, DO
-
Caylee Christina Bont, PA-C
-
Timothy M Bont, M.D.
-
Javin Hastin Brita, PA-C
-
Kayley Bruinsma, NP-C
-
Brooke Elizabeth Carter, PA-C
-
Randall J. Ceton, M.D.
-
Carol L. Deweerd, M.D.
-
Michael J. Deweerd, M.D.
-
Stephanie Ann Dublis, D.O.
-
Lauren Gullo, PA-C
-
Jennifer Kathleen Hall, PA-C
-
Angela Marie Heard, FNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MI
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
- Corporation · Non-profit
- Enrollment address
- 212 S Sullivan Ave
Fremont, MI 49412-1548 - Related CCNs
- 231338
All disclosed owners & managing parties 17
| Name | Role | Since | Share |
|---|---|---|---|
| Christina Freese Decker |
Corporate Director | Aug 18, 2020 | |
| Other |
Oct 1, 2018 | ||
| Talawnda L Bragg |
Corporate Director | Jan 1, 2022 | |
| Christopher B Port |
Corporate Director | Aug 18, 2020 | |
| Ronald M Hofman |
Corporate Director | Aug 18, 2020 | |
| Annica Euurand Waalkes |
Corporate Director | Aug 18, 2020 | |
| Teresa Arlene Treiber |
W-2 Managing Employee | Nov 1, 2025 | |
| Matthew E Cox |
Corporate Officer |
Feb 1, 2022 | |
| Operational/Managerial Control | Feb 1, 2022 | ||
| Mark Wilson |
Corporate Director | Aug 18, 2020 | |
| Corewell Health |
Operational/Managerial Control | Sep 27, 2010 | |
| Johannie M Torres |
Corporate Director | Aug 18, 2020 | |
| Mary Doornbos |
Corporate Director | Aug 18, 2020 | |
| John Buckley |
Corporate Director | Aug 18, 2020 | |
| Sam R Watson |
Corporate Director | Aug 18, 2020 | |
| Bill P Pink |
Corporate Director | Aug 18, 2020 | |
| Simin Beg |
Corporate Director | Aug 18, 2020 | |
| Lynnette Ferrell-Robinson |
Corporate Director | Aug 18, 2020 | |
| Tamila Marlow |
W-2 Managing Employee | Nov 1, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Part of
- Hesperia Medical Center
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | |||
| Rural Health Clinic/Center | 261QR1300X | Yes |
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
- Corewell Health Gerber Hospital Obstetrics and Gynecology
- Spectrum Health Gerber Memorial Obstetrics and Gynecology
Other providers in Fremont, MI
- Newaygo County General Hospital Association
- Newaygo County General Hospital Association
- Newaygo County General Hospital Association
- Newaygo County General Hospital Association
- Newaygo County General Hospital Association
- Newaygo County General Hospital Association
- Newaygo County General Hospital Association
- Newaygo County General Hospital Association
- Newaygo County General Hospital Association
- Newaygo County Resa
All providers in Fremont, MI · Rural Health Clinic/Center in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.