GTC OPCO, LLC (NPI# 1134645419) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134645419 |
| Entity Type | Organization |
| Organization Name | GTC OPCO, LLC |
| Other Organization Name | MEDILODGE OF GTC |
| Practice Address |
2950 Lafranier Rd Traverse City MI 49686-4918 |
| Mailing Address |
7400 New La Grange Rd Ste 100 Louisville KY 40222-4870 |
| Practice Telephone | 2319470506 |
| Mailing Telephone | 5024298062 |
| Mailing Fax Number | 5024290650 |
| Enumeration Date | 2017-08-17 |
| Last Update Date | 2017-08-28 |
| Authorized Official Name | MR. STACEY PAUL ROGERS (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 5024298062 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Medilodge of GTC | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | GTC OPCO, LLC | 2950 Lafranier Road, Traverse City, MI 49686-4918 |
| Street Address |
2950 LAFRANIER RD |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49686-4918 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750338521 | Birchwood Nursing Center Inc. | Skilled Nursing Facility | 2950 Lafranier Rd, Traverse City, MI 49686-4918 | 2006-05-27 |
| 1861957037 | Michael Adam Gold | Nurse Practitioner | 2950 Lafranier Rd, Traverse City, MI 49686-4918 | 2019-02-01 |
| 1063996056 | Nicole Ketcik | Physical Therapy Assistant | 2950 Lafranier Rd, Traverse City, MI 49686-4918 | 2018-09-17 |
| 1497246367 | Andrea M Fritz | Occupational Therapist | 2950 Lafranier Rd, Traverse City, MI 49686-4918 | 2018-05-25 |
| 1629574033 | Timothy John Zmudka | Speech-Language Pathologist | 2950 Lafranier Rd, Traverse City, MI 49686-4918 | 2018-04-04 |
| 1619470796 | Jessie Stockwell | Physical Therapy Assistant | 2950 Lafranier Rd, Traverse City, MI 49686-4918 | 2018-03-14 |
| 1972030864 | Chelsea Renell Fitzpatrick | Dietitian, Registered | 2950 Lafranier Rd, Traverse City, MI 49686-4918 | 2017-05-22 |
| 1023568110 | Clay Lemcool Maxwell Lemcool | Physical Therapy Assistant | 2950 Lafranier Rd, Traverse City, MI 49686-4918 | 2016-10-12 |
| 1861941056 | Sarah Gaby | Physical Therapy Assistant | 2950 Lafranier Rd, Traverse City, MI 49686-4918 | 2016-09-28 |
| 1609229665 | Cheryl Ann Walch | Nurse Practitioner | 2950 Lafranier Rd, Traverse City, MI 49686-4918 | 2016-07-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245877208 | Jessica Marie Glowacki | Behavior Technician | 935 Hemlock St, Traverse City, MI 49686 | 2019-12-09 |
| 1568011542 | Joanne Kressley | Technician | 1693 Maylane Apt. 104, Traverse City, MI 49686 | 2019-09-11 |
| 1194283846 | Pace North | PACE Provider Organization | 2325 Garfield Road N., Traverse City, MI 49686 | 2019-03-12 |
| 1245749225 | Margaret Anne Goss | Speech-Language Pathologist | 1105 E. Eighth Street, Traverse City, MI 49686 | 2017-09-22 |
| 1467981811 | Joan Joyce Shirilla | Social Worker | 2124 Twin Eagles Dr, Traverse City, MI 49686 | 2017-06-08 |
| 1770028763 | Rehab and Mobility Systems, LLC | Durable Medical Equipment & Medical Supplies | 707 Parsons, Traverse City, MI 49686 | 2016-12-29 |
| 1629511316 | Kaitlyn Grangood | Social Worker | 415 Munson Avenue, Ste 101, Traverse City, MI 49686 | 2016-11-29 |
| 1811441132 | Jeffrey D Goodwin | Counselor | 430 Fair St., Traverse City, MI 49686 | 2016-08-04 |
| 1053779918 | Thomas Osborne | Counselor | 2014 Phelps Rd., Traverse City, MI 49686 | 2016-02-08 |
| 1982079588 | Marsha Lynne Dallas | Counselor | 2240 South Airport Road, Traverse City, MI 49686 | 2015-12-08 |
| Find all providers in zip 49686 | ||||
| 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 |
|---|---|---|---|---|
| 1578688735 | Orchard Creek Health Care Inc | Skilled Nursing Facility | 9731 E Cherry Bend Rd, Traverse City, MI 49684-7621 | 2007-03-20 |
| 1386686624 | Tendercare Traverse City Inc. | Skilled Nursing Facility | 2585 Lafranier Rd, Traverse City, MI 49686-8972 | 2006-06-12 |
| 1750338521 | Birchwood Nursing Center Inc. | Skilled Nursing Facility | 2950 Lafranier Rd, Traverse City, MI 49686-4918 | 2006-05-27 |
| 1194242420 | Traverse City Opco Group, LLC | Skilled Nursing Facility | 2585 Lafranier Rd, Traverse City, MI 49686-8972 | 2017-08-28 |
| 1700266780 | Traverse City Opco, LLC | Skilled Nursing Facility | 2828 Concord St, Traverse City, MI 49684-4618 | 2015-06-04 |
| 1316345671 | Fmg Lafranier Drive Michigan LLC | Skilled Nursing Facility | 2585 Lafranier Rd, Traverse City, MI 49686-8972 | 2014-12-18 |
| 1033517461 | Fmg Lafranier Road Michigan LLC | Skilled Nursing Facility | 2950 Lafranier Rd, Traverse City, MI 49686-4918 | 2014-12-17 |
| 1649304270 | Grand Traverse Pavilions | Skilled Nursing Facility | 1000 Pavilions Circle, Traverse City, MI 49684 | 2007-03-15 |
| 1336226752 | Traverse Geriatric Village, Inc | Skilled Nursing Facility | 2828 Concord St, Traverse City, MI 49684-4618 | 2006-11-01 |
| 1326124322 | County of Grand Traverse | Skilled Nursing Facility | 1000 Pavilions Circle, Traverse City, MI 49684-3198 | 2006-10-31 |
| Find all providers in TRAVERSE CITY | ||||
| City | TRAVERSE CITY |
| Zip Code | 49686 |
Please comment or provide details below to improve the information on GTC OPCO, LLC.
| 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.