BRIAN RICHARD KOOIKER SR. (NPI# 1740718394) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740718394 |
| Entity Type | Individual |
| Full Name | BRIAN RICHARD KOOIKER SR. |
| Practice Address |
6909 Cannonsburg Rd Ne Belmont MI 49306-9123 |
| Practice Telephone | 6167456619 |
| Practice Fax Number | 6168836736 |
| Mailing Telephone | 6167456619 |
| Mailing Fax Number | 6168836736 |
| Enumeration Date | 2017-05-26 |
| Last Update Date | 2017-05-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
AF410356288 | MI | Nursing & Custodial Care Facilities |
| Street Address |
6909 CANNONSBURG RD NE |
| City | BELMONT |
| State | MI |
| Zip Code | 49306-9123 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750891206 | Charla Lee Sweat | Massage Therapist | 6290 Jupiter Drive, Suite C, Belmont, MI 49306 | 2017-10-10 |
| 1609385129 | Leigh Ann Moulton | Massage Therapist | 6290 Jupiter Drive Suite C, Belmont, MI 49306 | 2017-09-27 |
| 1194889915 | Kristen Rae Matusz | Physical Therapist | 6159 George Ann Ct., Belmont, MI 49306 | 2006-12-19 |
| 1851872683 | Ellen Roesler | Physical Therapist | 6290 Jupiter Ave Ne Ste C, Belmont, MI 49306 | 2018-08-29 |
| 1164061826 | Taylor L Walendzik | Specialist/Technologist | 2464 Bridle Way Ne, Belmont, MI 49306-7810 | 2019-12-29 |
| 1003135773 | Virginia M Hayataka | Massage Therapist | 3424 Keswick Dr Ne, Belmont, MI 49306-8600 | 2010-05-20 |
| 1366608754 | Prac Holdings, Inc. | Home Health | 2350 Belmont Ctr Dr Ne Ste 400, Belmont, MI 49306-8702 | 2008-08-05 |
| 1841511771 | Discovery Chiropractic LLC | Chiropractor | 2350 Belmont Center Dr Ne, Suite 200, Belmont, MI 49306-8706 | 2010-06-15 |
| 1003815002 | John Thomas Frey | Dentist | 6220 Jupiter Ave Ne, Suite B, Belmont, MI 49306-8708 | 2005-07-20 |
| 1285928960 | Rebecca Emma Roumayah | Dentist | 6220 Jupiter Ave Ne, Belmont, MI 49306-8708 | 2011-05-31 |
| Find all providers in zip 49306 | ||||
| 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 |
|---|---|---|---|---|
| 1487070769 | Mere-mor House | Custodial Care Facility | 4084 Tucker Rd, Belmont, NC 28012-8702 | 2014-03-11 |
| 1063747319 | Gary | Custodial Care Facility | 301 Mcauley Circle, Belmont, NC 28012-0710 | 2009-10-05 |
| 1801129127 | Lakewood | Custodial Care Facility | 302 Greenwood Pl, Belmont, NC 28012-2911 | 2009-09-18 |
| 1285861500 | Carrabaun | Custodial Care Facility | 303 Mcauley Circle, Belmont, NC 28012-0710 | 2009-06-12 |
| 1720107733 | Southpoint | Custodial Care Facility | 2352 Southpoint Rd, Belmont, NC 28012-7790 | 2007-03-29 |
| 1205912201 | House of Mercy, Inc. | Custodial Care Facility | 701 Mercy Drive, Belmont, NC 28012-0808 | 2006-10-31 |
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| 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 | ||||
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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.