NPIMap

Organization Active NPI

Memorial Medical Center of West Michigan

  • General Acute Care Hospital
  • Ludington, MI
National Provider Identifier
1972589489
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
MEMORIAL MEDICAL CENTER OF WEST MICHIGAN
Practice address
1 N Atkinson Dr
Ludington, MI 49431-1906
Phone
(231) 843-2591
Fax
(231) 845-3696
NPI assigned
Dec 16, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Authorized official

Name
Mr. Drew Dostal
Title
Regional Market Leader
Phone
(231) 924-1340

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary
Rural Acute Care Hospital 282NR1301X 530010 MI

Addresses

Primary practice location

1 N Atkinson Dr
Ludington, MI 49431-1906

Mailing address

1 N Atkinson Dr
Ludington, MI 49431-1906
Phone (231) 843-2591

Other identifiers 3

IdentifierTypeStateIssuer
0E36002OtherMIMEDICARE PART B
5171299MedicaidMI
1556026MedicaidMI

Other names 2

  • Corewell Health Ludington Hospital Doing business as
  • Spectrum Health Ludington Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040728000098 MI Part A Provider - Hospital 3678543659 Practice locations: Hart, MI; Ludington, MI
O20071128000647 MI Part B Supplier - Clinic/Group Practice 3678543659 Receives reassigned benefits from 185 practitioners
2 other NPIs on this enrollment
Practice locations: Scottsville, MI; Ludington, MI; Grant, MI; Hesperia, MI; Hart, MI
O20240109002912 MI Part B Supplier - Intensive Cardiac Rehabilitation 3678543659 Practice locations: Ludington, MI

Hospital certification: CCN 230110

Legal name
MEMORIAL MEDICAL CENTER OF WEST MICHIGAN
Doing business as
COREWELL HEALTH LUDINGTON HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Sep 13, 2018
Beds
81
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
1 N Atkinson Dr
Ludington, MI 49431-1906
Main/Primary Hospital Location
Hospital subgroups
Acute care

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

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Corewell Health Ludington HospitalCCN 230110
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

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
23D0379608Corewell Health Ludington Hospital1 Atkinson Drive, Ludington, MI 49431AccreditationJan 2, 2027

National Provider Directory

National Provider Directory

Locations

220 S James St
Ludington, MI 49431
Phone (231) 843-3700

300 W Broadway Ave
Scottville, MI 49454
Phone (231) 757-4831

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Whitney Eckhoff Individual W-2 Managing EmployeeManager, Provider Enrollment Oct 1, 2023
OtherManager, Provider Enrollment Oct 1, 2023
Christina Freese Decker Individual Corporate OfficerPresident & Ceo Corewell Health Aug 18, 2020
Talawnda L Bragg Individual Corporate DirectorBoard Member Jan 1, 2022
Christopher B Port Individual Corporate DirectorBoard Member Aug 18, 2020
Ronald M Hofman Individual Corporate DirectorBoard Member Aug 18, 2020
Annica Euurand Waalkes Individual Corporate DirectorBoard Member Aug 18, 2020
Matthew E Cox Individual Corporate OfficerChief Financial Officer Nov 2, 2022
Mark Wilson Individual Corporate DirectorBoard Member Aug 18, 2020
Corewell Health Organization, Grand Rapids, MI Corporation, Non-profit, Chain home office Operational/Managerial Control Oct 1, 2013 100%
Johannie M Torres Individual Corporate DirectorBoard Member Aug 18, 2020
Mary Doornbos Individual Corporate DirectorBoard Member Aug 18, 2020
John Buckley Individual Corporate DirectorBoard Member Aug 18, 2020
Drew H Dostal Individual Corporate OfficerPresident Ludington Hospital Aug 3, 2020 100%
Sam R Watson Individual Corporate DirectorBoard Member Aug 18, 2020
Bill P Pink Individual Corporate DirectorBoard Member Aug 18, 2020
Simin Beg Individual Corporate DirectorBoard Member Aug 18, 2020
Lynnette Ferrell-Robinson Individual Corporate DirectorBoard Member Aug 18, 2020
Tamila Marlow Individual W-2 Managing EmployeeAnalyst Revenue Cycle Sr Sep 1, 2020
Other Sep 1, 2020

Owners & managing parties with NPI records 5

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Corewell Health Ludington Hospital Family Medicine-HartHart, MI, CCN 238676 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2014

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 202

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

View all 202

Affiliated clinicians 367

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

View all 367

NPI Registry JSON

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692057600000",
    "number": "1972589489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 N ATKINSON DR",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494311906",
            "telephone_number": "231-843-2591",
            "fax_number": "231-845-3696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 N ATKINSON DR",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494311906",
            "telephone_number": "231-843-2591",
            "fax_number": "231-845-3696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL MEDICAL CENTER OF WEST MICHIGAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-16",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A",
        "authorized_official_last_name": "DOSTAL",
        "authorized_official_first_name": "DREW",
        "authorized_official_title_or_position": "REGIONAL MARKET LEADER",
        "authorized_official_telephone_number": "231-924-1340",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "MI",
            "license": "530010",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "0E36002",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5171299",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1556026",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corewell Health Ludington Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Spectrum Health Ludington Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Spectrum Health Ludington Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ludington, MI

Sources for this page

Verify at the official NPI Registry.