NPIMap

Organization Active NPI

Wellbridge of Fenton, LLC

  • Skilled Nursing Facility
  • Fenton, MI
National Provider Identifier
1104222520
Registry record updated Nov 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
WELLBRIDGE OF FENTON, LLC
Practice address
901 Pine Creek Drive
Fenton, MI 48430
Phone
(810) 623-5216
Fax
(517) 947-4450
NPI assigned
Nov 12, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2014

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

Authorized official

Name
Mr. Michael Daniel Perry, NHA
Title
Coo
Phone
(810) 623-5216

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

901 Pine Creek Drive
Fenton, MI 48430

Mailing address

901 Pine Creek Drive
Fenton, MI 48430
Phone (810) 623-5216

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160122000567 MI Part A Provider - Skilled Nursing Facility 1759695794 Practice locations: Fenton, MI

Skilled nursing facility certification: CCN 235715

Legal name
WELLBRIDGE OF FENTON, LLC
Doing business as
WELLBRIDGE OF FENTON
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Dec 21, 2015
Last certification
Dec 11, 2024
Beds
100
Ownership / control type
Corporation
Multi-facility organization
Nexcare Wellbridge
Organization structure
LLCProprietary
Incorporated
Dec 4, 2012 in MI
Enrollment address
901 Pinecreek Dr
Fenton, MI 48430-1978
Nursing home name
WELLBRIDGE OF FENTON
Affiliated entity
THE WELLBRIDGE GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
WellBridge of FentonCCN 235715 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Dec 21, 2015
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10089.3 residents per day on average
Chain
The Wellbridge Group8 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
James Branscum Individual 5% Or Greater Indirect Ownership Interest Dec 4, 2012 30.3%
Nexcare Health Systems, LLC Organization, Brighton, MI LLC Operational/Managerial Control Apr 1, 2016 10%
Michael D Perry Individual 5% Or Greater Direct Ownership InterestCeo Jan 1, 2016 5%
E2G, LLC Organization, Farmington Hills, MI LLC 5% Or Greater Direct Ownership Interest Dec 4, 2012 30.3%
Todd M Sangster Individual Corporate OfficerCfo Apr 1, 2016
Senior Care Equities No 16 LLC Organization, Brighton, MI Created for acquisition, LLC 5% Or Greater Direct Ownership Interest Dec 4, 2012 30.3%
Leo Eisenberg Individual 5% Or Greater Indirect Ownership Interest Dec 4, 2012 30.3%
Angela Tisch Individual W-2 Managing EmployeeExecutive Director Apr 16, 2021 100%
Frank M Wronski Individual 5% Or Greater Direct Ownership Interest Dec 4, 2014 30.3%

Facilities with the same owner 25

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

View all 25

Practitioners & affiliated clinicians

Practitioners 1

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": "1415750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415750400000",
    "number": "1104222520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 PINE CREEK DRIVE",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "48430",
            "telephone_number": "810-623-5216",
            "fax_number": "517-947-4450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 PINE CREEK DRIVE",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "48430",
            "telephone_number": "810-623-5216",
            "fax_number": "517-947-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLBRIDGE OF FENTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-12",
        "last_updated": "2014-11-12",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "810-623-5216",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MI

Sources for this page

Verify at the official NPI Registry.