MEDILODGE OF TAYLOR, INC. (NPI# 1609836220) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609836220 |
| Entity Type | Organization |
| Organization Name | MEDILODGE OF TAYLOR, INC. |
| Practice Address |
23600 Northline Rd Taylor MI 48180-4620 |
| Mailing Address |
64500 Van Dyke Rd Washington MI 48095-2583 |
| Practice Telephone | 7342878580 |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2008-07-29 |
| Authorized Official Name | KATHLEEN DENEAN (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 5867525008 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 824360 | MI | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 2695919 | 05 | |
| MI | BLUE CROSS OF MICHIGAN | 09998 | 01 |
| Street Address |
23600 NORTHLINE RD |
| City | TAYLOR |
| State | MI |
| Zip Code | 48180-4620 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871083923 | Monica Sarkar | Occupational Therapist | 23600 Northline Rd, Taylor, MI 48180-4620 | 2018-05-15 |
| 1891136115 | Taylor Opco LLC | Skilled Nursing Facility | 23600 Northline Rd, Taylor, MI 48180-4620 | 2013-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568920288 | Kenneth Harlan | Physical Therapist | 22606 Northline Rd., Taylor, MI 48180 | 2019-03-12 |
| 1790270916 | Ryan Thomas Sankovic | Physical Medicine & Rehabilitation | 10000 Telegraph Road, Taylor, MI 48180 | 2018-06-29 |
| 1538658026 | Deborah Moseley | Physical Therapist | 21308 Eureka Rd, Taylor, MI 48180 | 2018-05-09 |
| 1366944837 | Cheryl Lee Ivie | Nurse Practitioner | 26650 Eureka Rd Suite C, Taylor, MI 48180 | 2018-03-01 |
| 1619407376 | Markesha Lynn Smith | Case Manager/Care Coordinator | 26550 Eureka Road, Suite C, Taylor, MI 48180 | 2017-06-15 |
| 1376072645 | Chris James Clark | Massage Therapist | 11178 Katrine, Taylor, MI 48180 | 2017-06-08 |
| 1245767151 | Alexandre John Mazar | Student in an Organized Health Care Education/Training Program | 10000 Telegraph Road - Beaumont Taylor Hospital, Physical Medicine and Rehabilitation Department, Taylor, MI 48180 | 2017-05-23 |
| 1063949030 | Jared David Mccallum | Physical Medicine & Rehabilitation | Beaumont Hospital, Taylor - Attn: Chris L Birkenhauer, 10000 Telegraph Ro, Taylor, MI 48180 | 2017-05-22 |
| 1972039667 | Chante Lowman | Specialist/Technologist | 23774 Crisler St., Taylor, MI 48180 | 2017-05-02 |
| 1477003036 | Latricia Osborne | Licensed Practical Nurse | 94060e. Pickwick Circle, Taylor, MI 48180 | 2016-10-07 |
| Find all providers in zip 48180 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386718633 | Summit Health & Rehabilitation, LLC | Skilled Nursing Facility | 506 N. Long Ave., Taylor, AR 71861 | 2006-11-20 |
| 1396741922 | Taylor Nursing and Rehabilitation Center | Skilled Nursing Facility | 500 W Hospital St, Taylor, PA 18517-2012 | 2005-06-28 |
| 1013912922 | Park Nursing Center of Taylor, LLC | Skilled Nursing Facility | 12575 Telegraph Rd, Taylor, MI 48180-4019 | 2005-06-16 |
| 1164907846 | Guardian Elder Care At Taylor LLC | Skilled Nursing Facility | 500 W Hospital St, Taylor, PA 18517-2012 | 2018-09-28 |
| 1871020248 | Platinum Health At Riverside LLC | Skilled Nursing Facility | 500 W Hospital St, Taylor, PA 18517-2012 | 2017-05-17 |
| 1588061659 | Taylor 2 Opco, LLC | Skilled Nursing Facility | 22950 Northline Rd, Taylor, MI 48180-4696 | 2014-12-04 |
| 1073943320 | Rajeev Jose | Skilled Nursing Facility | 22950 Northline Rd, Taylor, MI 48180-4696 | 2013-11-23 |
| 1891136115 | Taylor Opco LLC | Skilled Nursing Facility | 23600 Northline Rd, Taylor, MI 48180-4620 | 2013-07-15 |
| 1003098666 | Taylor Health and Rehabilitation Center LLC | Skilled Nursing Facility | 500 W Hospital St, Taylor, PA 18517-2012 | 2007-12-05 |
| 1255530648 | Oakwood Healthcare Inc | Skilled Nursing Facility | 10000 Telegraph Rd, Taylor, MI 48180-3330 | 2007-07-16 |
| Find all providers in TAYLOR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.