Organization Active NPI

Grand Rapids Opco, LLC

  • Skilled Nursing Facility
  • Grand Rapids, MI
National Provider Identifier
1083347660
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
GRAND RAPIDS OPCO, LLC
Practice address
2000 Leonard St NE
Grand Rapids, MI 49505-5837
Phone
(616) 458-1133
Fax
(616) 458-0743
NPI assigned
Jul 1, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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

Authorized official

Name
Mr. Craig A Flashner
Title
LLC Member
Phone
(805) 819-3351

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

2000 Leonard St NE
Grand Rapids, MI 49505-5837

Mailing address

7400 New la Grange Rd Ste 400
Louisville, KY 40222-4870
Phone (502) 429-8069

Other names 1

  • Medilodge of Grand Rapids Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220912001065 MI Part A Provider - Skilled Nursing Facility 6305221383 Practice locations: Grand Rapids, MI

Skilled nursing facility certification: CCN 235038

Legal name
GRAND RAPIDS OPCO LLC
Doing business as
MEDILODGE OF GRAND RAPIDS
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1967
Last certification
Jun 4, 2025
Beds
55
Ownership / control type
Corporation
Most recent change of ownership
Sep 1, 2022
Organization structure
LLCProprietary
Incorporated
Jun 15, 2022 in DE
Enrollment address
2000 Leonard St NE
Grand Rapids, MI 49505-5837
Nursing home name
MEDILODGE OF GRAND RAPIDS
Affiliated entity
MEDILODGE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Medilodge of Grand RapidsCCN 235038
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jan 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5551.3 residents per day on average
Chain
Medilodge53 facilities in the chain
Penalties (3 years)
4Fines totaling $82,503

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Cody Healthcare S Corp Organization, Agoura Hills, CA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Sep 1, 2022 43.05%
B&Y Trust Organization, Brooklyn, NY 5% Or Greater Indirect Ownership Interest Sep 1, 2022 43.05%
Prestige Administrative Services, LLC Organization, Louisville, KY LLC, Consulting firm, For-profit Operational/Managerial Control Sep 1, 2022
Craig a Flashner Individual Corporate DirectorLLC Member Sep 1, 2022
Operational/Managerial ControlLLC Member Sep 1, 2022
Kristine Ranel Kirk Individual W-2 Managing EmployeeBusiness Manager Sep 1, 2022
Robert L Norcross Individual Contracted Managing EmployeeChief Executive Officer Sep 1, 2022
Craig Flashner 2007 Trust Organization, Agoura Hills, CA 5% Or Greater Indirect Ownership Interest Sep 1, 2022 43.05%
B&Y Healthcare S Corp Organization, Brooklyn, NY Corporation, For-profit 5% Or Greater Indirect Ownership Interest Sep 1, 2022 43.05%
Stacey Paul Rogers Individual Contracted Managing EmployeeChief Financial Officer Sep 1, 2022
Yitzchok a Perlstein Individual Corporate DirectorLLC Member Sep 1, 2022
Century Healthcare Management LLC Organization, Louisville, KY LLC, Management services company, For-profit Operational/Managerial Control Sep 1, 2022
Grand Rapids Holdco LLC Organization, Brooklyn, NY Created for acquisition, LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest Sep 1, 2022 100%

Facilities with the same owner 77

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 77

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1656633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718928000000",
    "number": "1083347660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 NEW LA GRANGE RD STE 400",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224870",
            "telephone_number": "502-429-8069",
            "fax_number": "866-360-1098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 LEONARD ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495055837",
            "telephone_number": "616-458-1133",
            "fax_number": "616-458-0743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND RAPIDS OPCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-01",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A",
        "authorized_official_last_name": "FLASHNER",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "LLC MEMBER",
        "authorized_official_telephone_number": "805-819-3351",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medilodge of Grand Rapids",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.