COREWELL HEALTH PENNOCK HOSPITAL FAMILY MEDICINE - LAKE ODESSA
NPI 1962889584
Clinic/Center - Rural Health in Lake Odessa, MI
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
Specialties & Licenses
Other Names 2
Other Identifiers 1
Accepted 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 23D0375784
Corewell Health Pennock Hospital Family Medicine - Lake Odessa · Lake Odessa, MIOther Providers at the Same Location NPPES 19
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
LAKE ODESSA, MI 48849
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 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.
# Corewell Health Pennock Hospital Family Medicine - Lake Odessa · NPI 1962889584
Rural Health organization in Lake Odessa, Michigan. Organization record, active in the CMS NPPES registry since May 4, 2015.
## Identity
- **NPI:** 1962889584 (Entity type: Organization)
- **Enumerated:** May 4, 2015
- **Primary specialty:** Clinic/Center - Rural Health · taxonomy 261QR1300X
- **Legal business name:** Pennock Hospital
- **Also known as:** Spectrum Health Pennock Family Medicine - Lake Odessa (Doing Business As)
- **Organization subpart:** Yes (part of Pennock Hospital)
- **Authorized official:** John Sella, CONTROLLER
## Practice location
- **Address:** 4294 LAUREL DR, Lake Odessa, MI 48849-8430
- **Phone:** (616) 374-7660 · **Fax:** (616) 374-0270
## Record status
- **NPPES last updated:** August 23, 2023
- **Other identifiers:** Other 238675 (MI)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1962889584) · Data from the CMS NPPES public registry.