Organization Active NPI

Newaygo Medical Care Facility

  • Skilled Nursing Facility
  • Fremont, MI
National Provider Identifier
1033168406
Registry record updated Nov 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
628510 Issued in MI
Legal business name
NEWAYGO MEDICAL CARE FACILITY
Practice address
4465 W 48TH St
Fremont, MI 49412-8721
Phone
(231) 924-2020
Fax
(231) 924-2366
NPI assigned
May 10, 2006
Last updated
Nov 16, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Judith Ann Still, LNHA, BSN, RN
Title
Administrator
Phone
(231) 924-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 628510 MI Primary

Addresses

Primary practice location

4465 W 48TH St
Fremont, MI 49412-8721

Mailing address

4465 W 48TH Street
Fremont, MI 49412
Phone (231) 924-2020

Other identifiers 1

IdentifierTypeStateIssuer
612085259MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111202000388 MI Part A Provider - Skilled Nursing Facility 9335314368 Practice locations: Fremont, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1033168406. Details of each certification follow.

Skilled nursing facility certification: CCN 235076

Legal name
NEWAYGO MEDICAL CARE FACILITY
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1967
Last certification
May 1, 2025
Beds
116
Ownership / control type
Other Nonprofit
Organization structure
GovernmentNon-profit
Enrollment address
4465 W 48TH St
Fremont, MI 49412-8721
Nursing home name
NEWAYGO CO MEDICAL CARE FACILITY

Care Compare: Nursing home

Medicare Care Compare
Listed as
Newaygo Co Medical Care FacilityCCN 235076 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
5 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Other
Certified
Jan 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
11659.0 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0708051Newaygo Medical Care Facility4465 W 48TH Street, Fremont, MI 49412Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kimberly Updike Individual Operational/Managerial Control Aug 1, 2021
Patricia Gray Individual Corporate DirectorAdministrator Jul 9, 2024 100%
Operational/Managerial Control Apr 25, 2025
Adp of the SNF Apr 25, 2025
Michael Mercer Individual Corporate DirectorBoard Chair Jan 1, 2015
County of Newaygo Organization, White Cloud, MI 5% Or Greater Direct Ownership Interest Jan 1, 1966 100%
Krystyna Barbara Solarewicz Individual Operational/Managerial Control May 1, 2022
Adp of the SNF Jun 27, 2025
Philip Alt Individual Operational/Managerial Control Oct 2, 2025
Adp of the SNF Oct 2, 2025

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447632000000",
    "number": "1033168406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4465 W 48TH STREET",
            "city": "FREMONT",
            "state": "MI",
            "postal_code": "49412",
            "telephone_number": "231-924-2020",
            "fax_number": "231-924-2366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4465 W 48TH ST",
            "city": "FREMONT",
            "state": "MI",
            "postal_code": "494128721",
            "telephone_number": "231-924-2020",
            "fax_number": "231-924-2366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWAYGO MEDICAL CARE FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2015-11-16",
        "status": "A",
        "authorized_official_last_name": "STILL",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "231-924-2020",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LNHA, BSN, RN"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MI",
            "license": "628510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "612085259",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, MI

Sources for this page

Verify at the official NPI Registry.