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COREWELL HEALTH PENNOCK HOSPITAL FAMILY MEDICINE - GUN LAKE
NPI 1801250907
Clinic/Center - Rural Health in Wayland, MI

Active since April 05, 2016CLIA 23D0899819 · Waiver
12851 W M 179 HWY, WAYLAND, MI 49348(877) 377-7322 Get Directions Write a Review

NPPES record last updated: August 23, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Corewell Health Pennock Hospital Family Medicine - Gun Lake NPPES

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

COREWELL HEALTH PENNOCK HOSPITAL FAMILY MEDICINE - GUN LAKE (NPI 1801250907) is a healthcare organization registered as a rural health in Wayland, Michigan and active in the NPI registry since April 2016. The organization holds a CLIA Waiver certificate valid through October 31, 2027 and lists John Sella, Controller, as its authorized official.

NPPES Registry Identity

NPI1801250907
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NamePENNOCK HOSPITAL
Location Address12851 W M 179 HWYWayland, MI 49348-9318
Mailing Address100 Michigan St Ne, Mc 845Grand Rapids, MI 49503-2560
Phone(877) 377-7322
Organization SubpartYes
Authorized OfficialJohn SellaController · (616) 802-0206
Enumeration DateApril 5, 2016
Last NPPES UpdateAugust 23, 2023
NPPES CertifiedAugust 23, 2023
✔ NPI 1801250907 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
12851 W M 179 HWY, Wayland, MI 49348
Open in Google Maps ↗

Other Names 2

Doing Business AsCorewell Health Pennock Hospital Family Medicine - Gun Lake
Doing Business AsSpectrum Health Pennock Family Medicine - Gun Lake

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company.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 23D0899819

Corewell Health Pennock Hospital Family Medicine - Gun Lake · Wayland, MI
Active · expires Oct 31, 2027
CLIA Number23D0899819
Laboratory TypeRural Health Clinic
Certificate Effective DateNovember 1, 2025
Certificate Expiration DateOctober 31, 2027
Laboratory DirectorJoshua D. Knudson
Laboratory Phone(877) 377-7322
Laboratory LocationCorewell Health Pennock Hospital Family Medicine - Gun Lake12851 W M-179 Hwy, Wayland, MI 49348
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 14

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

TABITHA JANE EWERT PA-C
Physician Assistant
12851 W M 179 HWY
WAYLAND, MI 49348
Allegan County (877) 377-7322
PENNOCK HOSPITAL
Family Medicine
12851 W M 179 HWY
WAYLAND, MI 49348
Allegan County (877) 377-7322
MURIEL ANN ARROWSMITH FNP
Nurse Practitioner (Family)
12851 W M 179 HWY
WAYLAND, MI 49348
Allegan County (877) 377-7322
DR. LAWRENCE S HAWKINS M.D.
Family Medicine
12851 W M 179 HWY
WAYLAND, MI 49348
Allegan County (877) 377-7322
KENDEL WIERCINSKI
Nurse Practitioner (Family)
12851 W M 179 HWY
WAYLAND, MI 49348
Allegan County (877) 377-7322
DR. DOUGLAS JAMES SMENDIK MD
Family Medicine
12851 W M 179 HWY
WAYLAND, MI 49348
Allegan County (877) 377-7322
PENNOCK PHARMACY
Pharmacy (Community/Retail Pharmacy)
12851 W M 179 HWY
WAYLAND, MI 49348
Allegan County (269) 945-8050
JOSHUA DUVAR KNUDSON MD
Family Medicine
12851 W M 179 HWY
WAYLAND, MI 49348
Allegan County (877) 377-7322

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 1801250907. It was assigned to this organization in the NPPES registry on April 5, 2016. The provider is doing business as Corewell Health Pennock Hospital Family Medicine - Gun Lake and Spectrum Health Pennock Family Medicine - Gun Lake.

Where is Pennock Hospital located?

Pennock Hospital is located at 12851 W M 179 Hwy, Wayland, MI 49348. The listed phone number is (877) 377-7322.

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 23D0899819) is associated with this NPI, valid through October 31, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Pennock Hospital accept?

Health plans from 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.