NPIMap

Organization Active NPI

Hackley Hospital

Doing business as Women's Center Clinic-Lakeshore

  • Health Service Clinic/Center
  • Shelby, MI
National Provider Identifier
1831245992
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
HACKLEY HOSPITAL
Doing business as
Women's Center Clinic-Lakeshore
Practice address
72 S State St
Shelby, MI 49455-1228
Phone
(231) 861-2156
NPI assigned
Jan 25, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Marjorie Young
Title
VP
Phone
(231) 727-7951

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

72 S State St
Shelby, MI 49455-1228

Mailing address

6401 Prairie St
Suite 2300
Muskegon, MI 49444-7840
Phone (231) 727-7944

Other names 1

  • WOMEN'S CENTER CLINIC-LAKESHORE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1831245992. Details of each certification follow.

Hospital certification: CCN 230171

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
HACKLEY LAKESHORE HOSPITAL
Certification status
Terminated Other: provider status change, Oct 1, 2004
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
May 4, 1989
Beds
24
Ownership / control type
Local
Facility address
72 S State St
Shelby, MI 49455

National Provider Directory

National Provider Directory
Tax ID family
Hackley Hospital12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

72 S State St
Shelby, MI 49455
Phone (231) 728-4601

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831245992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6401 PRAIRIE ST",
            "address_2": "SUITE 2300",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494447840",
            "telephone_number": "231-727-7944",
            "fax_number": "231-724-7812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 S STATE ST",
            "city": "SHELBY",
            "state": "MI",
            "postal_code": "494551228",
            "telephone_number": "231-861-2156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HACKLEY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "MARJORIE",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "231-727-7951"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WOMEN'S CENTER CLINIC-LAKESHORE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shelby, MI

Sources for this page

Verify at the official NPI Registry.