BEVERLY JEAN MEDFORD (NPI# 1710461090) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710461090 |
| Entity Type | Individual |
| Full Name | BEVERLY JEAN MEDFORD |
| Practice Address |
9318 E. Pickard Rd. Mount Pleasant Mi MI 48858 |
| Mailing Address |
9318 E Pickard Rd Mount Pleasant MI 48858-9463 |
| Practice Telephone | 9897727588 |
| Mailing Telephone | 9897727588 |
| Enumeration Date | 2018-09-21 |
| Last Update Date | 2018-09-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
AF370393943 | MI | Nursing & Custodial Care Facilities |
| Street Address |
9318 E. PICKARD RD. |
| City | MOUNT PLEASANT MI |
| State | MI |
| Zip Code | 48858 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215535067 | Family Tree Maternity Center, LLC | Midwife | 5201 S. Mission Rd., Mt. Pleasant, MI 48858 | 2020-10-14 |
| 1942842471 | Isabella Citizens for Health, Inc. | Pharmacy | 2790 Health Parkway, Mt Pleasant, MI 48858 | 2019-10-16 |
| 1295299279 | Dalten Tyler Simnitch | Student in an Organized Health Care Education/Training Program | 3700 E Deerfield Rd, Lexington Ridge E01, Mount Pleasant, MI 48858 | 2019-01-24 |
| 1942773809 | Jordan Lynn Bell | Technician, Other | 798 S Whilteville Rd, Mount Pleasant, MI 48858 | 2019-01-03 |
| 1083183578 | Amanda Danielle Greene | Student in an Organized Health Care Education/Training Program | 1280 E. Campus Dr., Central Michigan University, Mt. Pleasant, MI 48858 | 2018-11-14 |
| 1891264388 | Emily Mccullen | Student in an Organized Health Care Education/Training Program | 1280 E Campus Drive, Central Michigan University, Mount Pleasant, MI 48858 | 2018-11-14 |
| 1174092662 | Nathaniel Lambie | Student in an Organized Health Care Education/Training Program | 1280 East Campus Drive, Central Michigan University, Mount Pleasant, MI 48858 | 2018-11-14 |
| 1386110872 | Megan Stahl | Social Worker | 301 S Crapo St Suite 100, Mt.pleasant, MI 48858 | 2018-10-23 |
| 1760976211 | Jen Carlesimo | Behavior Technician | Central Autism Treatment Center, 2520 S. University Park Drive, Building D, Mt. Pleasant, MI 48858 | 2018-06-19 |
| 1558862367 | Justin Bobick | Physical Therapist | 4851 East Pickard Street, 2600, Mt Pleasant, MI 48858 | 2018-02-27 |
| Find all providers in zip 48858 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881201267 | Living Waters Buell Lake | Custodial Care Facility | 13515 N Genesee Rd, Clio, MI 48420-9190 | 2020-09-29 |
| 1063028694 | Zcare | Custodial Care Facility | 8676 Auburn St, Detroit, MI 48228-2919 | 2020-09-18 |
| 1306452917 | Caring Hearts Afc | Custodial Care Facility | 1029 Westmoreland Ave, Kalamazoo, MI 49006-5567 | 2020-09-18 |
| 1790397594 | St. Ruth's House of Hope LLC | Custodial Care Facility | 3100 S Electric St, Detroit, MI 48217-1133 | 2020-08-21 |
| 1497364442 | Bolton Brook Manor | Custodial Care Facility | 4554 Thomas Rd, Metamora, MI 48455-9220 | 2020-07-27 |
| 1578171104 | Dream Housing Opportunities LLC | Custodial Care Facility | 304 Wetmore St, Howell, MI 48843-1559 | 2020-07-20 |
| 1194343046 | Creekside Place, Inc. | Custodial Care Facility | 7251 N Briarcliff Knoll Dr, West Bloomfield, MI 48322-4049 | 2020-07-08 |
| 1174140420 | Linda Perrault | Custodial Care Facility | 1551 S Hickory Ridge Rd, Milford, MI 48380-1519 | 2020-07-02 |
| 1063039923 | Visel Afc, Inc. | Custodial Care Facility | 6565 Whitneyville Ave Se, Alto, MI 49302-9027 | 2020-06-26 |
| 1982226775 | August Winter House, Inc. | Custodial Care Facility | 2111 N Latson Rd, Howell, MI 48855-9750 | 2020-05-14 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT PLEASANT MI |
| Zip Code | 48858 |
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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.