GRAND TRAVERSE PAVILIONS (NPI# 1649304270) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649304270 |
| Entity Type | Organization |
| Organization Name | GRAND TRAVERSE PAVILIONS |
| Practice Address |
1000 Pavilions Circle Traverse City MI 49684 |
| Practice Telephone | 2319323000 |
| Mailing Telephone | 2319323000 |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2007-07-16 |
| Authorized Official Name | MR. RICHARD MARION JR. (CEO) |
| Authorized Official Telephone | 2319323000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE CROSS NUMBER | 30395 | 01 |
| Street Address |
1000 PAVILIONS CIRCLE |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49684 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073585238 | Mark A Jackson | Family Medicine | 1000 Pavilions Circle, Mark A Jackson Md Plc, Traverse City, MI 49684 | 2006-02-02 |
| 1265924542 | Katrina Torgerson | Physical Therapist | 1000 Pavilions Circle, Traverse City, MI 49684 | 2018-06-03 |
| 1326124322 | County of Grand Traverse | Skilled Nursing Facility | 1000 Pavilions Circle, Traverse City, MI 49684-3198 | 2006-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124641758 | Karen Anne Paulosky | Registered Nurse | 226 S Madison St, Traverse City, MI 49684 | 2020-05-18 |
| 1891314795 | Jaclyn Elizabeth Sylvain | Student in an Organized Health Care Education/Training Program | Munson Family Practice Center, 1400 Medical Campus Drive, Traverse City, MI 49684 | 2020-04-10 |
| 1285282988 | Madelyn Drumm | Dietitian, Registered | 217 S. Madison St., Suite 3022, Traverse City, MI 49684 | 2019-08-27 |
| 1265917686 | Kacie Danielle Heading | Social Worker | 12719 S. West Bay Shore Drive, Suite 9, Traverse City, MI 49684 | 2018-10-02 |
| 1881178325 | Jacob White Ph.d., Pllc | Psychologist | 3537 W. Front Street, Suite F, Traverse City, MI 49684 | 2018-09-20 |
| 1144702572 | Constance Baab, Phd, Lmsw, Pllc | Social Worker | 3301 Veterans Drive Suite 127, Traverse City, MI 49684 | 2018-09-01 |
| 1346732880 | The Skin Cancer and Dermatology Center Plc | Dermatology | 1225 W Front St Ste 2, Traverse City, MI 49684 | 2018-05-31 |
| 1790283851 | Lisa Louise Kleyps | Massage Therapist | 3337 W. South Airport Road #2, Traverse City, MI 49684 | 2018-01-24 |
| 1114447646 | Brittany Alexandra Prior | Physical Therapist | 3899 W Front Sreet, Unit 3, Traverse City, MI 49684 | 2017-06-26 |
| 1568902963 | Jennifer Scott | Behavior Technician | 515 W 14th St Unit D, Traverse City, MI 49684 | 2017-03-03 |
| Find all providers in zip 49684 | ||||
| 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 |
| 1134645419 | Gtc Opco, LLC | Skilled Nursing Facility | 2950 Lafranier Rd, Traverse City, MI 49686-4918 | 2017-08-17 |
| 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 |
| 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 | 49684 |
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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.