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COREWELL HEALTH PENNOCK HOSPITAL FAMILY MEDICINE - LAKE ODESSA
NPI 1962889584
Clinic/Center - Rural Health in Lake Odessa, MI

Active since May 04, 2015
4294 LAUREL DR, LAKE ODESSA, MI 48849(616) 374-7660(616) 374-0270 Get Directions Write a Review

NPPES record last updated: August 23, 2023. Verified against the NPPES registry weekly; last sync: September 13, 2026.

Record update history: Aug 23, 2023, Sep 20, 2016, Nov 19, 2015 (3 updates tracked since 2015).

About Corewell Health Pennock Hospital Family Medicine - Lake Odessa NPPES

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

COREWELL HEALTH PENNOCK HOSPITAL FAMILY MEDICINE - LAKE ODESSA (NPI 1962889584) is a healthcare organization registered as a rural health in Lake Odessa, Michigan and active in the NPI registry since May 2015. The organization lists John Sella, Controller, as its authorized official.

NPPES Registry Identity

NPI1962889584
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NamePENNOCK HOSPITAL
Location Address4294 LAUREL DRLake Odessa, MI 48849-8430
Mailing Address100 Michigan St Ne, Mc 845Grand Rapids, MI 49503-2560
Phone(616) 374-7660
Fax(616) 374-0270
Organization SubpartYes
Authorized OfficialJohn SellaController · (616) 802-0206
Enumeration DateMay 4, 2015
Last NPPES UpdateAugust 23, 20233 updates tracked since enumeration
NPPES CertifiedAugust 23, 2023
✔ NPI 1962889584 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
4294 LAUREL DR, Lake Odessa, MI 48849
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Other Names 2

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

Other Identifiers 1

Other238675MI · Medicare Ptan

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 ›

Other Providers at the Same Location NPPES 19

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

MICHELLE VANBUREN NP
Nurse Practitioner (Family)
4294 LAUREL DR
LAKE ODESSA, MI 48849
Ionia County (616) 374-7660
PENNOCK HOSPITAL BOARD OF TRUSTEES
General Acute Care Hospital
4294 LAUREL DR
LAKE ODESSA, MI 48849
Ionia County (269) 945-1212
DR. LAURIE S BRAKER MD
Family Medicine
4294 LAUREL DR
LAKE ODESSA, MI 48849
Ionia County (616) 374-7660
MR. JONATHAN ALVARO
Physician Assistant
4294 LAUREL DR
LAKE ODESSA, MI 48849
Ionia County (616) 374-7660
LEE O STUART MD
Family Medicine
4294 LAUREL DR
LAKE ODESSA, MI 48849
Ionia County (616) 374-7660
PENNOCK HOSPITAL
Family Medicine
4294 LAUREL DR
LAKE ODESSA, MI 48849
Ionia County (616) 374-7660
PINE REST CHRISTIAN MENTAL HEALTH SERVICES
Psychiatry & Neurology (Psychiatry)
4294 LAUREL DR
LAKE ODESSA, MI 48849
Ionia County (616) 891-8770
GABRIEL NEIL PA-C
Physician Assistant
4294 LAUREL DR
LAKE ODESSA, MI 48849
Ionia County (616) 374-7660

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 1962889584. It was assigned to this organization in the NPPES registry on May 4, 2015. The provider is doing business as Corewell Health Pennock Hospital Family Medicine - Lake Odessa and Spectrum Health Pennock Family Medicine - Lake Odessa.

Where is Pennock Hospital located?

Pennock Hospital is located at 4294 Laurel Dr, Lake Odessa, MI 48849. The listed phone number is (616) 374-7660.

What is Pennock Hospital's specialty?

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

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 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.