Crestview SNF, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CRESTVIEW SNF, LLC

Doing business as

Illuminate HC Wyoming
SKLD Wyoming

Practice address

625 36TH St SW
Wyoming, MI 49509

Phone

(616) 531-0200

NPI assigned

May 9, 2018

Last updated

Aug 17, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Yair Zuckerman

Title

Manager

Phone

(773) 517-4777

Specialties & licenses 1

Addresses

Other names 2

• Illuminate HC Wyoming Doing business as
• SKLD Wyoming Doing business as

Practitioners 3

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.

• Noelle K Franklyn, MD

  • Family Medicine Physician
  • North Muskegon, MI
  • NPI 1235145244
  NPD (past)
• Gregg Thomas Malicke, D.O.

  • Emergency Medicine Physician
  • Big Rapids, MI
  • NPI 1417211087
  NPD (past)
• Miriam Yvonne Veldt, MD

  • Family Medicine Physician
  • Portage, MI
  • NPI 1295965499
  NPD (past)

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

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1073002606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 DAVIS ST STE 200",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 36TH ST SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "49509",
            "telephone_number": "616-531-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTVIEW SNF, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-09",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "ZUCKERMAN",
        "authorized_official_first_name": "YAIR",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "773-517-4777"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Illuminate HC Wyoming",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SKLD Wyoming",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Crabb, RD
• Craft Chiropractic Center PC
• Mica Latice Craig, LPN
• Kaely Shaye Crawford, PA
• Stephanie Cressman
• Julie Crites
• Avery Cross
• Julie Mabry Cross
• Amy Crum
• Melanie A Crum, RDN

• Skilled Nursing Facility in Wyoming, MI
• Providers in Wyoming, MI by specialty
• Skilled Nursing Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.