CLARK RETIREMENT COMMUNITY, INC. (NPI# 1265421051) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265421051 |
| Entity Type | Organization |
| Organization Name | CLARK RETIREMENT COMMUNITY, INC. |
| Practice Address |
1551 Franklin St Se Grand Rapids MI 49506 |
| Practice Telephone | 6164521568 |
| Practice Fax Number | 6162479625 |
| Mailing Telephone | 6164521568 |
| Mailing Fax Number | 6162479625 |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2015-04-07 |
| Authorized Official Name | MR. BRIAN A PANGLE (PRESIDENT/CEO) |
| Authorized Official Telephone | 6164521568 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 235401 | MI | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 2081269 | 05 |
| Street Address |
1551 FRANKLIN ST SE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811510258 | Kimberly Hartger | Recreational Therapist Assistant | 1551 Franklin St Se, Grand Rapids, MI 49506-8203 | 2020-05-20 |
| 1174771026 | Clark Retirement Community Inc. | Home Health | 1551 Franklin St Se, Grand Rapids, MI 49506-8203 | 2008-09-04 |
| 1871741249 | Clark Retirement Community Inc. | Home Health | 1551 Franklin St Se, Grand Rapids, MI 49506-8203 | 2008-08-28 |
| 1235331257 | Mary Claire Podein | Physical Therapist | 1551 Franklin St Se, Grand Rapids, MI 49506-8203 | 2007-06-01 |
| 1497956353 | Stephanie Adams | Occupational Therapy Assistant | 1551 Franklin St Se, Grand Rapids, MI 49506-8203 | 2007-05-29 |
| 1023170412 | Clark Retirement Pharmacy | Pharmacy | 1551 Franklin St Se, Grand Rapids, MI 49506-8203 | 2006-12-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356954705 | Mckenna Shank | Technician | 1409 E Beltline Ave Se, Grand Rapids, MI 49506 | 2020-08-26 |
| 1750917969 | Meghan Elizabeth Southwell | Social Worker | Counseling Center of West Michigan, 360 East Beltline Ave Ne Suite 100, Grand Rapids, MI 49506 | 2020-03-19 |
| 1356876536 | Lisa Finkbeiner | Chiropractor | 1324 Lake Dr Se Ste 1, Grand Rapids, MI 49506 | 2017-04-26 |
| 1447622964 | Ashley Robinson | Rehabilitation Practitioner | 1490 East Beltline Ave, Grand Rapids, MI 49506 | 2015-10-23 |
| 1770951584 | Stuart Segal | Behavioral Analyst | 1415 Wealthy St Se Apt 312, Grand Rapids, MI 49506 | 2015-09-10 |
| 1922476373 | Elizabeth Taylor | Nurse Practitioner | 2255 Wealthy Dr., Grand Rapids, MI 49506 | 2015-09-02 |
| 1780066092 | Carole Walters Counseling | Social Worker | 959 Wealthy St. Se, Grand Rapids, MI 49506 | 2015-06-23 |
| 1053792697 | Rosemary F. Trimpe | Social Worker | 4255 Kalamazoo Se, Grand Rapids, MI 49506 | 2015-06-09 |
| 1164809919 | Gary James | Rehabilitation Practitioner | 1490 E. Beltline Se, Grand Rapids, MI 49506 | 2015-04-30 |
| 1275925315 | Paul Cole | Counselor | 1101 Ball Ave. .se., Grand Rapids, MI 49506 | 2015-02-26 |
| Find all providers in zip 49506 | ||||
| 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 |
|---|---|---|---|---|
| 1396975546 | Porter Hills Presbyterian Village, Inc. | Skilled Nursing Facility | 1029 E Paris Ave Se, Grand Rapids, MI 49546-3603 | 2009-07-22 |
| 1578739827 | St Ann's Home | Skilled Nursing Facility | 2161 Leonard Nw, Grand Rapids, MI 49504 | 2008-05-07 |
| 1922296730 | Lisa Ann Mervenne | Skilled Nursing Facility | 2520 Lake Michigan Dr Nw, Grand Rapids, MI 49504-4696 | 2007-10-05 |
| 1730256207 | Welcov Healthcare LLC | Skilled Nursing Facility | 2801 S Highway 169, Grand Rapids, MN 55744-9552 | 2006-11-29 |
| 1992892525 | Trinity Continuing Care Services | Skilled Nursing Facility | 1050 4 Mile Rd Nw, Grand Rapids, MI 49544-1505 | 2006-10-06 |
| 1568554566 | Covenant Living of The Great Lakes | Skilled Nursing Facility | 2520 Lake Michigan Drive Nw, Grand Rapids, MI 49504-4696 | 2006-09-28 |
| 1235141151 | Cascade Care Center, Inc | Skilled Nursing Facility | 1095 Medical Park Dr Se, Grand Rapids, MI 49546-3607 | 2006-08-12 |
| 1033137005 | Audrich, Inc. | Skilled Nursing Facility | 24201 3rd St, Grand Rapids, OH 43522-9785 | 2006-07-18 |
| 1205878998 | Heartland of Grand Rapids Mi LLC | Skilled Nursing Facility | 2320 E Beltline Ave Se, Grand Rapids, MI 49546-5906 | 2006-06-10 |
| 1184662793 | Itasca Nursing Home | Skilled Nursing Facility | 923 Hale Lake Pointe, Grand Rapids, MN 55744-9615 | 2006-06-04 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49506 |
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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.