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COREWELL HEALTH PENNOCK HOSPITAL FAMILY MEDICINE - STATE ST
NPI 1396190138
Clinic/Center - Rural Health in Hastings, MI

Active since April 29, 2016CLIA 23D2013566 · Waiver
1108 W STATE ST, SUITE 3, HASTINGS, MI 49058(269) 945-0922 Get Directions Write a Review

NPPES record last updated: August 23, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 23, 2023, Aug 9, 2016 (2 updates tracked since 2016).

About Corewell Health Pennock Hospital Family Medicine - State St NPPES

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

COREWELL HEALTH PENNOCK HOSPITAL FAMILY MEDICINE - STATE ST (NPI 1396190138) is a healthcare organization registered as a rural health in Hastings, Michigan and active in the NPI registry since April 2016. The organization holds a CLIA Waiver certificate valid through May 18, 2028 and lists John Sella, Controller, as its authorized official.

NPPES Registry Identity

NPI1396190138
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NamePENNOCK HOSPITAL
Location Address1108 W STATE ST, SUITE 3Hastings, MI 49058-9711
Mailing Address100 Michigan St Ne, Mc 845Grand Rapids, MI 49503-2560
Phone(269) 945-0922
Organization SubpartYes
Authorized OfficialJohn SellaController · (616) 802-0206
Enumeration DateApril 29, 2016
Last NPPES UpdateAugust 23, 20232 updates tracked since enumeration
NPPES CertifiedAugust 23, 2023
✔ NPI 1396190138 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
1108 W STATE ST, Hastings, MI 49058
Open in Google Maps ↗

Other Names 2

Doing Business AsCorewell Health Pennock Hospital Family Medicine - State St
Doing Business AsSpectrum Health Pennock Family, Internal & Pediatric Medicine - Hastin

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

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 23D2013566

Corewell Health Pennock Hospital Family Medicine - State St · Hastings, MI
Active · expires May 18, 2028
CLIA Number23D2013566
Laboratory TypeRural Health Clinic
Certificate Effective DateMay 19, 2026
Certificate Expiration DateMay 18, 2028
Laboratory DirectorCarl J. Baker
Laboratory Phone(269) 945-0922
Laboratory LocationCorewell Health Pennock Hospital Family Medicine - State St1108 W State Street Suite 3, Hastings, MI 49058
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 11

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

ALIA ANTHONY
Nurse Practitioner
1108 W STATE ST, SUITE 3
HASTINGS, MI 49058
Barry County (269) 945-0922
MRS. TIFFANY R JACKSON NP
Nurse Practitioner
1108 W STATE ST, SUITE 3
HASTINGS, MI 49058
Barry County (269) 945-0922
ADAM FARRELL PA-C
Physician Assistant
1108 W STATE ST
HASTINGS, MI 49058
Barry County (269) 948-3102
LEON VANDERLAAN PA-C
Physician Assistant
1108 W STATE ST
HASTINGS, MI 49058
Barry County (269) 948-3102
PENNOCK HOSPITAL BOARD OF TRUSTEES
Family Medicine
1108 W STATE ST
HASTINGS, MI 49058
Barry County (269) 945-8080
AMBER JUHL NP
Nurse Practitioner (Family)
1108 W STATE ST
HASTINGS, MI 49058
Barry County (269) 948-3360
DR. LAURA J KOTA MD
Obstetrics & Gynecology
1108 W STATE ST, SUITE 3
HASTINGS, MI 49058
Barry County (269) 945-8080
WOMENS HEALTH FIRST PC
Obstetrics & Gynecology
1108 W STATE ST, SUITE 3
HASTINGS, MI 49058
Barry County (269) 945-8080

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 Pennock Hospital's NPI number?

The NPI number for Pennock Hospital is 1396190138. It was assigned to this organization in the NPPES registry on April 29, 2016. The provider is doing business as Corewell Health Pennock Hospital Family Medicine - State St and Spectrum Health Pennock Family, Internal & Pediatric Medicine - Hastin.

Where is Pennock Hospital located?

Pennock Hospital is located at 1108 W State St Suite 3, Hastings, MI 49058. The listed phone number is (269) 945-0922.

What is Pennock Hospital's specialty?

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

Does Pennock Hospital hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D2013566) is associated with this NPI, valid through May 18, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Pennock Hospital 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 Pennock Hospital 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 Pennock Hospital was last updated on August 23, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.