NPIMap

Bronson Lakeview Hospital

Organization Active NPI Critical Access Hospital · Paw Paw, MI

NPI 1962508259 · NPPES record last updated Dec 27, 2023

Key facts

NPI
1962508259
Entity type
Organization (NPI type 2)
Primary specialty
Critical Access Hospital 282NC0060X
Legal business name
BRONSON LAKEVIEW HOSPITAL
Practice address
408 Hazen St
Paw Paw, MI 49079-1019
Phone
(269) 657-3141
Fax
(269) 657-1474
NPI assigned
Sep 15, 2006
Organization subpart
No

Authorized official

Name
Rebecca East
Title
SVP, Cfo
Phone
(269) 341-6000

Owners & managing parties with NPI records 7

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

Other NPIs with the same Medicare PAC ID 5

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

Subparts reporting this organization as parent 4

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

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

Facilities with the same owner 11

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

Practitioners 116

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 116

Affiliated clinicians 538

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 538

Medicare Care Compare: Hospital

Listed as
Bronson Lakeview Hospital CCN 231332
Overall star rating
★★★★★ 5 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0377848Bronson Lakeview Hospital
408 Hazen Street, Paw Paw, MI 49079		AccreditationJan 2, 2027
23D2223069Bronson Lakeview Hospital Ancillary Testing
408 Hazen Street, Paw Paw, MI 49079		Certificate of waiverMay 3, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in MI

Hospital certification: CCN 231332

Legal name
BRONSON LAKEVIEW HOSPITAL
Doing business as
BRONSON LAKEVIEW HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Dec 1, 2005
Last certification
Oct 13, 2016
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
Corporation · Non-profit
Enrollment address
408 Hazen St
Paw Paw, MI 49079-1019

Hospital certification: CCN 23Z332

Legal name
BRONSON LAKEVIEW HOSPITAL
Organization structure
Corporation · Non-profit
Incorporated
Jan 1, 1990 in MI
Enrollment address
408 Hazen St
Paw Paw, MI 49079-1019
Hospital Swing-Bed Unit

All disclosed owners & managing parties 35

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

NameRoleSinceShare
Bill Harold Manns
Individual 		Corporate Officer May 13, 2020
Penny a Miller
Individual 		W-2 Managing Employee
Provider Enrollment		 Jan 1, 2022
W-2 Managing Employee
Provider Enrollment		 Jan 1, 2022
Mike Way
Individual 		Corporate Officer
SVP		 Jan 1, 1986
Rebecca East
Individual 		Corporate Officer
SVP, Cfo		 Feb 1, 2015
W-2 Managing Employee
SVP, Cfo		 Feb 1, 2015
Corporate Officer
SVP, Cfo		 Feb 1, 2015
W-2 Managing Employee
SVP, Cfo		 Feb 1, 2015
Lajune Montgomery-Tabron
Individual 		Corporate Director
Board Member		 Jul 1, 2011
Corporate Director
Board Member		 Jul 1, 2011
Denise Neely
Individual 		Corporate Officer
SVP, Coo		 Jan 1, 2005
Corporate Officer
SVP, Coo		 Jan 1, 2005
Michael F Odar
Individual 		Corporate Director
Director		 Jul 1, 2016
Corporate Director Jul 1, 2016
Steven J Lins
Individual 		Corporate Director
Board Member		 Jul 1, 2011
Corporate Director
Board Member		 Jul 1, 2011
Barbara L James
Individual 		Corporate Director Jan 1, 2008
Emilee Nason
Individual 		W-2 Managing Employee Apr 24, 2020
Susan Reinoehl
Individual 		Corporate Officer
SVP, Cso		 Jan 1, 1995
Corporate Officer
SVP, Cso		 Jan 1, 1995
Ashley Rhoderick
Individual 		W-2 Managing Employee Apr 24, 2020
Mark B Atkinson
Individual 		Corporate Director
Director		 Sep 28, 2012
James L Liggins
Individual 		Corporate Director
Director		 Jan 1, 2016
Cheryl Johnson
Individual 		Corporate Officer
SVP, Cpo		 Jan 1, 2021
Corporate Officer
SVP, Cpo		 Jan 1, 2021
Leigh Ann Colegrove
Individual 		W-2 Managing Employee
System Credentialing Coordinator		 Oct 11, 2021
William D Johnston
Individual 		Corporate Director
Board Member		 Jul 1, 2011
Corporate Director
Board Member		 Jul 1, 2011
Jorge Gonzalez
Individual 		Corporate Director
Director		 Jan 1, 2018
Richard J Allen
Individual 		Corporate Director
Director		 Jan 1, 2017
Bronson Health Care Group Inc
Organization · Kalamazoo, MI
Non-profit 		5% Or Greater Direct Ownership Interest Jan 1, 2008 100%
Operational/Managerial Control Jan 1, 2008
Jamie N Squires
Individual 		W-2 Managing Employee
Provider Enrollment		 Jan 1, 2022
W-2 Managing Employee
Provider Enrollment		 Jan 1, 2022
Scott Larson
Individual 		Corporate Officer
SVP Cmo		 Jun 1, 2014
W-2 Managing Employee
SVP Cmo		 Jun 1, 2014
Corporate Officer
SVP Cmo		 Jun 1, 2014
W-2 Managing Employee
SVP Cmo		 Jun 1, 2014
Sridhar Chalasani
Individual 		Corporate Officer
System Chief of Staff		 Jan 1, 2020
Corporate Officer
System Chief of Staff		 Jan 1, 2020
Mary Fink
Individual 		Corporate Director
Director		 Jan 1, 2017
Scott C Gibson
Individual 		Corporate Director Jun 1, 2008
Mahesh C Karamchandani
Individual 		Corporate Director
Board Member		 Jul 1, 2011
Corporate Director Jul 1, 2011
Scott B Davidson
Individual 		Corporate Director
Director		 Sep 22, 2016
Randall W. Eberts
Individual 		Corporate Director Jan 1, 2008
Marisa Eason
Individual 		W-2 Managing Employee
Provider Enrollment		 Jan 1, 2022
W-2 Managing Employee
Provider Enrollment		 Jan 1, 2022
Brenda L Hunt
Individual 		Corporate Director
Board Member		 Jul 1, 2011
Corporate Director Jul 1, 2011
Donald R. Parfet
Individual 		Corporate Director Jan 1, 2008
Kirk Richardson
Individual 		Corporate Officer
VP Chief Operating Officer Chief		 Jun 1, 2014
W-2 Managing Employee
VP Chief Operating Officer Chief		 Jun 1, 2014
James B Falahee
Individual 		Corporate Officer
SVP Legal and Legislative Affair		 Jun 1, 2014
W-2 Managing Employee
SVP Legal & Legislative Affairs		 Jun 1, 2014
W-2 Managing Employee
SVP Legal & Legislative Affairs		 Jun 1, 2014
Neil Nyberg
Individual 		Corporate Director
Board Member		 Jul 1, 2011
Corporate Director
Board Member		 Jul 1, 2011
Nelson Karre
Individual 		Corporate Director
Board Member		 Jul 1, 2011
Corporate Director
Board Member		 Jul 1, 2011

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20080516000276 MI Part a Provider - Critical Access Hospital 9032008495 Receives reassigned benefits from 43 practitioners
Practice locations: Mattawan, MI; Paw Paw, MI
O20220526001376 MI Part a Provider - Critical Access Hospital 9032008495 Practice locations: Paw Paw, MI

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X
Critical Access Hospital 282NC0060X Yes

Addresses

Primary practice location

408 Hazen St
Paw Paw, MI 49079-1019

Mailing address

601 John St
Box 42
Kalamazoo, MI 49007-5341
Phone (269) 341-7806

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct

Other providers in Paw Paw, MI

All providers in Paw Paw, MI · Critical Access Hospital in Michigan

Sources for this page

Verify at the official NPI Registry.