SPECTRUM HEALTH PENNOCK
NPI 1326495326
Family Medicine in Caledonia, MI

Q: What is the provider's specialty?

The provider's specialty is Family Medicine with taxonomy code 207Q00000X.

Active since May 19, 2016

9090 S RODGERS CT SE, CALEDONIA, MI 49316(616) 891-0422 Get Directions Write a Review

NPPES record last updated: May 19, 2016. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Spectrum Health Pennock NPPES

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

SPECTRUM HEALTH PENNOCK (NPI 1326495326) is a healthcare organization registered as a family medicine in Caledonia, Michigan and active in the NPI registry since May 2016. The organization lists Deidre Weller, Controller, as its authorized official.

NPPES Registry Identity

NPI1326495326

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NamePENNOCK HOSPITAL

Location Address9090 S RODGERS CT SECaledonia, MI 49316-8052

Mailing Address100 Michigan St Ne, Mc 845Grand Rapids, MI 49503-2560

Phone(616) 891-0422

Organization SubpartYes

Authorized OfficialDeidre WellerController · (269) 948-3122

Enumeration DateMay 19, 2016

✔ NPI 1326495326 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedNurse PractitionerTaxonomy 363L00000X

9090 S RODGERS CT SE, Caledonia, MI 49316

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Other Names 1

Doing Business AsSpectrum Health Pennock

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

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 for Provider-Performed Microscopy Procedures (PPMP) 23D1103777

Corewell Health Family Medicine - Caledonia · Caledonia, MI

Expired · Apr 2, 2026

CLIA Number23D1103777

Laboratory TypePhysician Office

Certificate Effective DateApril 3, 2024

Certificate Expiration DateApril 2, 2026

Laboratory DirectorAdam Z. Mitchell

Laboratory Phone(616) 891-0422

Laboratory LocationCorewell Health Family Medicine - Caledonia9090 S Rodgers Ct SE Suite A, Caledonia, MI 49316

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 18

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

DR. RICHARD CLYDE ROBERTSON DDS

Dentist (General Practice)