NPIMap

Organization Active NPI

Memorial Center of West Michigan

  • Surgery Physician
  • Ludington, MI
National Provider Identifier
1669842308
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
MEMORIAL CENTER OF WEST MICHIGAN
Practice address
7 N Atkinson Dr
Ludington, MI 49431-1953
Phone
(231) 843-3717
NPI assigned
Oct 6, 2015
Organization subpart
Yes
Parent organization
MEMORIAL CENTER OF WEST MICHIGANAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Authorized official

Name
Kerri Nelson
Title
VP Finance
Phone
(231) 845-2251

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

7 N Atkinson Dr
Ludington, MI 49431-1953

Mailing address

100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560
Phone (616) 486-6790

Other names 1

  • Corewell Health Ludington Hospital Telemedicine Clinic - Mason County Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2297153Corewell Health Addiction Clinic - Ludington7 Atkinson Drive Suite 302, Ludington, MI 49431Certificate of waiverJan 10, 2028

National Provider Directory

National Provider Directory
Tax ID family
William Sutter20 organizations share this tax ID, including this one
Part of
William Sutter

Other organizations with this tax ID 19

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

View all 19

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1444089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693267200000",
    "number": "1669842308",
    "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",
            "telephone_number": "616-486-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 N ATKINSON DR",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494311953",
            "telephone_number": "231-843-3717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL CENTER OF WEST MICHIGAN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEMORIAL CENTER OF WEST MICHIGAN",
        "enumeration_date": "2015-10-06",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "KERRI",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "231-845-2251"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corewell Health Ludington Hospital Telemedicine Clinic - Mason County",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ludington, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.