{"npi":"1962889584","type":"NPI-2","status":"active","name":{"display":"Pennock Hospital","other":[],"organization_name":"PENNOCK HOSPITAL","authorised_official":"John Sella"},"specialty":{"primary_taxonomy":"261QR1300X","primary_taxonomy_description":"Rural Health Clinic/Center","slug":"rural-health-clinic-center","schema_org_specialty":null,"all":[{"code":"261QR1300X","description":"Rural Health Clinic/Center","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"4294 LAUREL DR","city":"LAKE ODESSA","state":"MI","postal_code":"488498430","country_code":"US","phone":"6163747660","fax":"6163740270"},{"purpose":"MAILING","street_1":"100 MICHIGAN ST NE","city":"GRAND RAPIDS","state":"MI","postal_code":"495032560","country_code":"US","street_2":"MC 845"}],"license":null,"identifiers":[{"type_code":"01","label":"Other","value":"238675","state":"MI","issuer":"MEDICARE PTAN"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20180928001557","type_code":"00-17","type_desc":"PART A PROVIDER - RURAL HEALTH CLINIC","state":"MI","pac_id":"4587551015"}]},"enumeration_date":"2015-05-04","last_updated":"2023-08-23","_meta":{"source":"NPPES","snapshot_date":"2023-08-23","doc_url":"https://findmynpi.com/api"}}