Corewell Health Watervliet Hospital Primary Care - Hartford | |
525 S Center St Hartford MI 49057-1362 | |
(269) 621-4063 | |
(269) 621-9972 |
Full Name | Corewell Health Watervliet Hospital Primary Care - Hartford |
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Speciality | Clinic/Center |
Location | 525 S Center St, Hartford, Michigan |
Authorized Official Name and Position | Matthew Cox (CFO) |
Authorized Official Contact | 6169153777 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Corewell Health Watervliet Hospital Primary Care - Hartford 400 Medical Park Drive Watervliet MI 49098 Ph: (269) 463-2448 | Corewell Health Watervliet Hospital Primary Care - Hartford 525 S Center St Hartford MI 49057-1362 Ph: (269) 621-4063 |
NPI Number | 1023114741 |
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Provider Enumeration Date | 09/16/2006 |
Last Update Date | 04/01/2023 |
Medicare PECOS PAC ID | 7416942750 |
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Medicare Enrollment ID | O20040416000984 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023114741 | NPI | - | NPPES |
700A160280 | Other | MI | BCBSM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Provider Name | John R Gosling |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1851387302 PECOS PAC ID: 4789676487 Enrollment ID: I20040409000114 |
Provider Name | Donald Frederick Brooks |
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Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1790733293 PECOS PAC ID: 7214994052 Enrollment ID: I20041214000427 |
Provider Name | Robert Scott Schaefer |
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Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1932195393 PECOS PAC ID: 3173417482 Enrollment ID: I20050221000496 |
Provider Name | Sean W Sullivan |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1194762286 PECOS PAC ID: 5597718486 Enrollment ID: I20050303000169 |
Provider Name | Bruce P Hackworth |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1063448918 PECOS PAC ID: 2062456031 Enrollment ID: I20050610000813 |
Provider Name | Lois G Lello |
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Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1255367850 PECOS PAC ID: 7911934880 Enrollment ID: I20050721000919 |
Provider Name | Christopher J Harvey |
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Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1265460489 PECOS PAC ID: 0941230080 Enrollment ID: I20050817001080 |
Provider Name | Leanne Marie Miller |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1326077744 PECOS PAC ID: 9931121670 Enrollment ID: I20051222000311 |
Provider Name | David A Puzycki |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1952478281 PECOS PAC ID: 2062413560 Enrollment ID: I20070126000103 |
Provider Name | Gerald A Friedman |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1346217445 PECOS PAC ID: 9537262795 Enrollment ID: I20070404000253 |
Provider Name | Ernest Buck |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1861504987 PECOS PAC ID: 2567443039 Enrollment ID: I20071026000674 |
Provider Name | Ewanah Johnson |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1841282456 PECOS PAC ID: 4284717364 Enrollment ID: I20080213000042 |
Provider Name | Jeffery T Postma |
---|---|
Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1154340693 PECOS PAC ID: 8729162607 Enrollment ID: I20080303000149 |
Provider Name | Dale G Leffler |
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Provider Type | Practitioner - Interventional Cardiology |
Provider Identifiers | NPI Number: 1346463254 PECOS PAC ID: 7810074655 Enrollment ID: I20080404000075 |
Provider Name | John R Spriegel |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1235146721 PECOS PAC ID: 5496839128 Enrollment ID: I20080915000560 |
Provider Name | Jason L Ford |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1063463933 PECOS PAC ID: 0446270474 Enrollment ID: I20090121000231 |
Provider Name | Michael E Mayle |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1851403307 PECOS PAC ID: 1254496979 Enrollment ID: I20090213000319 |
Provider Name | Michael P Maskill |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1184886111 PECOS PAC ID: 4385710474 Enrollment ID: I20090810000472 |
Provider Name | Shannon K Twiddy |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1386899292 PECOS PAC ID: 9830235738 Enrollment ID: I20091007000190 |
Provider Name | Brad S Ferrari |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1518995828 PECOS PAC ID: 2961545942 Enrollment ID: I20100130000358 |
Provider Name | Daniel M Metzger |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1265478192 PECOS PAC ID: 1052495785 Enrollment ID: I20100205000471 |
Provider Name | Joseph S Mashni |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1265424527 PECOS PAC ID: 1759439441 Enrollment ID: I20100521000384 |
Provider Name | Rebecca J Burnau |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1538482237 PECOS PAC ID: 3072647353 Enrollment ID: I20100823000843 |
Provider Name | Ryan S Klanseck |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1811195712 PECOS PAC ID: 0941493522 Enrollment ID: I20101015000667 |
Provider Name | James Clancy |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1679539811 PECOS PAC ID: 0042353005 Enrollment ID: I20101103000783 |
Provider Name | Charlotte Lofgren |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1154529436 PECOS PAC ID: 6507054269 Enrollment ID: I20101221001161 |
Provider Name | Jonathan R Steen |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1750543849 PECOS PAC ID: 3072784404 Enrollment ID: I20110915000509 |
Provider Name | Jonathan Nykamp |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144519133 PECOS PAC ID: 3779755939 Enrollment ID: I20111012000084 |
Provider Name | Shan E Abbas |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1730362674 PECOS PAC ID: 5597920272 Enrollment ID: I20120702000303 |
Provider Name | Nancy Jo Fantetti |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1891054458 PECOS PAC ID: 0244485639 Enrollment ID: I20130727000175 |
Provider Name | Brian E Bates |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1558317446 PECOS PAC ID: 9133020167 Enrollment ID: I20131003000595 |
Provider Name | Jay V Shah |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1487974663 PECOS PAC ID: 1658506373 Enrollment ID: I20131104001500 |
Provider Name | Todd W Haney |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598198673 PECOS PAC ID: 7618102187 Enrollment ID: I20131109000234 |
Provider Name | Tobin Jay Klint |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1407260201 PECOS PAC ID: 7416175294 Enrollment ID: I20140820002683 |
Provider Name | Angelique Y Madison |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417358995 PECOS PAC ID: 9436474244 Enrollment ID: I20150218001341 |
Provider Name | James Thomas Maskill |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1992064497 PECOS PAC ID: 3072730654 Enrollment ID: I20150810000438 |
Provider Name | Elizabeth A Mcglothlin |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1124394945 PECOS PAC ID: 9931414000 Enrollment ID: I20150818005941 |
Provider Name | Brandi A Smith |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1265898878 PECOS PAC ID: 8628372810 Enrollment ID: I20160209001055 |
Provider Name | Amanda Mills |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1174984413 PECOS PAC ID: 3870884810 Enrollment ID: I20160621002871 |
Provider Name | Evan Tank |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1124316054 PECOS PAC ID: 9931417813 Enrollment ID: I20160623000568 |
Provider Name | Prakash T Shrestha |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1427045392 PECOS PAC ID: 4486630456 Enrollment ID: I20160801002729 |
Provider Name | Susan K Kasko |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1609219070 PECOS PAC ID: 6901030535 Enrollment ID: I20161025002180 |
Provider Name | Olivia Cochran |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1184176786 PECOS PAC ID: 3274815840 Enrollment ID: I20170117001876 |
Provider Name | Janelle M Cornforth |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1558801068 PECOS PAC ID: 5890062012 Enrollment ID: I20170518001510 |
Provider Name | Jonathan Patrick Egle |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1346470176 PECOS PAC ID: 5799041976 Enrollment ID: I20171102003600 |
Provider Name | Meredith Marie Krugh |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1639684178 PECOS PAC ID: 6901167220 Enrollment ID: I20180301002562 |
Provider Name | Erin Nichole Hayden |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841707106 PECOS PAC ID: 3678835170 Enrollment ID: I20180321001497 |
Provider Name | Tanya Sobaski |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1205322534 PECOS PAC ID: 3870841885 Enrollment ID: I20180808001250 |
Provider Name | Dennis L Disch |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1003812926 PECOS PAC ID: 2860394376 Enrollment ID: I20180910000539 |
Provider Name | Raul Hector Torres |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1982041620 PECOS PAC ID: 2163731373 Enrollment ID: I20181106002479 |
Provider Name | Deanna Margaret Rucano |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1174011316 PECOS PAC ID: 0042554321 Enrollment ID: I20181128001543 |
Provider Name | Erika Suzanne Nearpass |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1053725267 PECOS PAC ID: 8628387578 Enrollment ID: I20190821001085 |
Provider Name | Tringo Dessie |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326695552 PECOS PAC ID: 9739419474 Enrollment ID: I20190924001238 |
Provider Name | Duston Boyd |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1538521331 PECOS PAC ID: 7719276963 Enrollment ID: I20191004001778 |
Provider Name | Celia Stenfors-dacre |
---|---|
Provider Type | Practitioner - Physical Medicine And Rehabilitation |
Provider Identifiers | NPI Number: 1780895581 PECOS PAC ID: 5698665552 Enrollment ID: I20191108001790 |
Provider Name | Kathryn M Vera |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1861033599 PECOS PAC ID: 1557794948 Enrollment ID: I20191125001541 |
Provider Name | Marlene Dee Ford |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1255382164 PECOS PAC ID: 5395766786 Enrollment ID: I20191213001586 |
Provider Name | Lindsey Catherine Healy |
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Provider Type | Practitioner - Physical Medicine And Rehabilitation |
Provider Identifiers | NPI Number: 1386007029 PECOS PAC ID: 4385056381 Enrollment ID: I20201216001316 |
Provider Name | James Strycker |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1134533565 PECOS PAC ID: 1254557804 Enrollment ID: I20201218001898 |
Provider Name | Barbara Glassford |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1891207320 PECOS PAC ID: 6103183504 Enrollment ID: I20210201000469 |
Provider Name | Laura I Gonzalez |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306438288 PECOS PAC ID: 8224443312 Enrollment ID: I20210223002590 |
Provider Name | Edward Chen |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1992110316 PECOS PAC ID: 0143640748 Enrollment ID: I20210326001618 |
Provider Name | Willie E Lawrence |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1851345466 PECOS PAC ID: 2860304326 Enrollment ID: I20210429001343 |
Provider Name | Sarah Hop |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1003303546 PECOS PAC ID: 1951706746 Enrollment ID: I20210817001473 |
Provider Name | Natasha Victoria Gordon |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1245803568 PECOS PAC ID: 8426453226 Enrollment ID: I20210817001871 |
Provider Name | Michelle Lynn Powell |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1073269445 PECOS PAC ID: 8123405107 Enrollment ID: I20220512001205 |
Provider Name | John Philip Markovic |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1770903189 PECOS PAC ID: 2163649880 Enrollment ID: I20220609000436 |
Provider Name | Luke William Linscheid |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598495988 PECOS PAC ID: 2961884150 Enrollment ID: I20220804002040 |
Provider Name | Gretchen L Carlson |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1225108152 PECOS PAC ID: 6204219975 Enrollment ID: I20220812000423 |
Provider Name | Megan P Samples |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1043612724 PECOS PAC ID: 1557738119 Enrollment ID: I20221110002105 |
Provider Name | Lindsey A Olson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1114685807 PECOS PAC ID: 8628440849 Enrollment ID: I20230215002017 |
Provider Name | William Ward |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1689657785 PECOS PAC ID: 8022144047 Enrollment ID: I20230317001390 |
Provider Name | David Mcintosh |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1770215428 PECOS PAC ID: 1658757208 Enrollment ID: I20230319000011 |
Provider Name | Laura C Trail |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548955412 PECOS PAC ID: 2466811856 Enrollment ID: I20230703001173 |
Provider Name | Sarah L Thordarson |
---|---|
Provider Type | Practitioner - Physical Medicine And Rehabilitation |
Provider Identifiers | NPI Number: 1275196933 PECOS PAC ID: 2062873474 Enrollment ID: I20230802000670 |
Provider Name | Jon Andrew Ferlmann |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1669001046 PECOS PAC ID: 2961863295 Enrollment ID: I20230802001551 |
Provider Name | Andrea Edgerly |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922506948 PECOS PAC ID: 0941561872 Enrollment ID: I20230908001575 |
Four Winds Casino Resort Hartford Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 68600 Red Arrow Hwy, Hartford, MI 49057 Phone: 269-637-9519 | |
Subhaschandra R Ravi Md Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 30 W Main St, Hartford, MI 49057 Phone: 269-621-2166 Fax: 269-621-2566 | |
Holy Family Healthcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2 E Main St, Hartford, MI 49057 Phone: 269-621-0011 Fax: 269-308-3336 |