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COREWELL HEALTH WATERVLIET HOSPITAL PRIMARY CARE - HARTFORD
NPI 1023114741
Clinic/Center - Rural Health in Hartford, MI

Active since September 16, 2006CLIA Certified · 3 labs
525 S CENTER ST, HARTFORD, MI 49057(269) 621-4063(269) 621-9972 Get Directions Write a Review

NPPES record last updated: April 1, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 1, 2023, Mar 24, 2023 (2 updates tracked since 2023).

About Corewell Health Watervliet Hospital Primary Care - Hartford NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COREWELL HEALTH WATERVLIET HOSPITAL PRIMARY CARE - HARTFORD (NPI 1023114741) is a healthcare organization registered as a rural health in Hartford, Michigan and active in the NPI registry since September 2006. The organization holds 3 active CLIA laboratory certificates and lists Matthew Cox, Cfo, as its authorized official.

NPPES Registry Identity

NPI1023114741
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameLAKELAND COMMUNITY HOSPITAL WATERVLIET
Location Address525 S CENTER STHartford, MI 49057-1362
Mailing Address400 Medical Park DriveWatervliet, MI 49098 · (269) 463-2448 · Fax (269) 463-5351
Phone(269) 621-4063
Fax(269) 621-9972
Organization SubpartYesParent: Corewell Health
Authorized OfficialMatthew CoxCfo · (616) 915-3777
Enumeration DateSeptember 16, 2006
Last NPPES UpdateApril 1, 20232 updates tracked since enumeration
NPPES CertifiedApril 1, 2023
✔ NPI 1023114741 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
Also ListedFamily MedicineTaxonomy 207Q00000X
525 S CENTER ST, Hartford, MI 49057
Open in Google Maps ↗

Other Names 1

Doing Business AsCorewell Health Watervliet Hospital Primary Care - Hartford

Other Identifiers 1

Other700A160280MI · Bcbsm

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D1074718

Corewell Health Watervliet Hospital Primary Care · Watervliet, MI
Active · expires Oct 3, 2027
CLIA Number23D1074718
Laboratory TypeRural Health Clinic
Certificate Effective DateOctober 4, 2025
Certificate Expiration DateOctober 3, 2027
Laboratory DirectorErika Nearpass
Laboratory Phone(269) 463-3600
Laboratory LocationCorewell Health Watervliet Hospital Primary Care400 Medical Park Drive, Watervliet, MI 49098
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Accreditation 23D0378152

Corewell Health Watervliet Hospital · Watervliet, MI
Active · expires Jan 2, 2027
CLIA Number23D0378152
Laboratory TypeHospital
Certificate Effective DateJanuary 3, 2025
Certificate Expiration DateJanuary 2, 2027
Laboratory DirectorDr. Jeffrey L. Hinson
Laboratory Phone(269) 983-8311
Laboratory LocationCorewell Health Watervliet Hospital400 Medical Park Dr, Watervliet, MI 49098
CLIA data matches this NPI record on: Address Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Waiver 23D0714794

Corewell Health Watervliet Hospital Primary Care - Hartford · Hartford, MI
Active · expires Dec 20, 2026
CLIA Number23D0714794
Laboratory TypeRural Health Clinic
Certificate Effective DateDecember 21, 2024
Certificate Expiration DateDecember 20, 2026
Laboratory DirectorJay V. Shah
Laboratory Phone(269) 463-3600
Laboratory LocationCorewell Health Watervliet Hospital Primary Care - Hartford525 S Center Street, Hartford, MI 49057
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANN MARIE TAPPER FNP-C
Nurse Practitioner
525 S CENTER ST
HARTFORD, MI 49057
Van Buren County (269) 463-3600
LAURA IRENE GONZALEZ NP
Nurse Practitioner (Family)
525 S CENTER ST
HARTFORD, MI 49057
Van Buren County (269) 463-3600
KELLIE DISTEFANO PA-C
Family Medicine
525 S CENTER ST
HARTFORD, MI 49057
Van Buren County (269) 621-4063
JAY SHAH M.D.
Family Medicine
525 S CENTER ST
HARTFORD, MI 49057
Van Buren County (269) 463-3600
MRS. TAMARA NICHOLE GAISHIN PA-C
Physician Assistant
525 S CENTER ST
HARTFORD, MI 49057
Van Buren County (269) 463-3600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lakeland Community Hospital Watervliet's NPI number?

The NPI number for Lakeland Community Hospital Watervliet is 1023114741. It was assigned to this organization in the NPPES registry on September 16, 2006. The provider is doing business as Corewell Health Watervliet Hospital Primary Care - Hartford.

Where is Lakeland Community Hospital Watervliet located?

Lakeland Community Hospital Watervliet is located at 525 S Center St, Hartford, MI 49057. The listed phone number is (269) 621-4063.

What is Lakeland Community Hospital Watervliet's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Lakeland Community Hospital Watervliet hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Lakeland Community Hospital Watervliet accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Lakeland Community Hospital Watervliet as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lakeland Community Hospital Watervliet was last updated on April 1, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.