NPIMap

Organization Active NPI

McLaren Lapeer Region

  • Skilled Nursing Facility
  • Lapeer, MI
National Provider Identifier
1104917079
Registry record updated Jun 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MCLAREN LAPEER REGION
Practice address
1375 N Main St
Lapeer, MI 48446-1350
Phone
(810) 667-5500
Fax
(810) 342-1335
NPI assigned
Sep 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2019

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

Authorized official

Name
Fred Korte
Title
VP/Cfo
Phone
(810) 342-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1375 N Main St
Lapeer, MI 48446-1350

Mailing address

1375 N Main St
Lapeer, MI 48446-1350
Phone (810) 667-5500

Other identifiers 4

IdentifierTypeStateIssuer
09943OtherMIBCBSM
0000004OtherMIHEALTHPLUS OF MICHIGAN
13549OtherMIBLUE CARE NETWORK
62 3407428MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100622000814 MI Part A Provider - Skilled Nursing Facility 4486759016 Practice locations: Lapeer, MI

Skilled nursing facility certification: CCN 235577

Legal name
MCLAREN LAPEER REGION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 8, 1997
Last certification
Sep 9, 2024
Beds
19
Ownership / control type
Corporation
Multi-facility organization
McLaren Healthcare
Organization structure
CorporationNon-profit
Incorporated
Aug 12, 1986 in MI
Enrollment address
1375 N Main St
Lapeer, MI 48446-1350
Nursing home name
MCLAREN LAPEER REGION

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
McLaren Lapeer RegionCCN 235577
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
5 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jul 8, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
1917.1 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Lapeer Regional Hospita8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1375 N Main St
#M
Lapeer, MI 48446

951 S Main St
Lapeer, MI 48446

809 W Dryden Rd
Metamora, MI 48455
Phone (810) 678-4000

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
Eric E Burrough Individual Corporate DirectorTrustee Jan 1, 2016
Trustee of the SNF Jan 1, 2016
Tiffany Davis Individual Corporate OfficerVP/Cfo McLaren Lapeer Feb 19, 2025
Operational/Managerial Control Feb 19, 2025
Trustee of the SNF Feb 19, 2025
Majed Al Nounou Individual Corporate DirectorTrustee Feb 19, 2025
Trustee of the SNF Feb 19, 2025
Chad Grant Individual Corporate DirectorTrustee Jul 29, 2019
Trustee of the SNF Jul 29, 2019
D. Wesley Smith Individual Corporate DirectorTrustee Feb 19, 2025
Trustee of the SNF Feb 19, 2025
Robert Riehl Individual Corporate DirectorTrustee Feb 19, 2025
Trustee of the SNF Feb 19, 2025
Philip a Incarnati Individual Corporate DirectorTrustee Oct 1, 1992
Trustee of the SNF Oct 1, 1992
Michael Burke Individual Corporate DirectorTrustee Mar 30, 2020
Trustee of the SNF Mar 30, 2020
Vishnu Kant Sharma Individual Corporate DirectorMedical Director Mar 19, 2025
Operational/Managerial Control Mar 19, 2025
Adp of the SNF Mar 25, 2025
Justus Scott Individual Corporate DirectorTrustee Jan 1, 2003
Trustee of the SNF Jan 1, 2003
McLaren Health Care Corporation Organization, Grand Blanc, MI Corporation, Non-profit 5% Or Greater Direct Ownership Interest Oct 1, 1992 100%
Operational/Managerial Control Oct 1, 1992
Adp of the SNF Oct 1, 1992
Direct Ownership Interest Oct 1, 1992 100%
Timothy D Vargas Individual Corporate OfficerPresident/Ceo McLaren Lapeer Feb 19, 2025
Operational/Managerial Control Feb 19, 2025
Trustee of the SNF Feb 19, 2025
Adp of the SNF Mar 19, 2025

Owners & managing parties with NPI records 2

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

Facilities with the same owner 58

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

View all 58

Practitioners & affiliated clinicians

Practitioners 17

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

View all 17

Affiliated clinicians 3

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": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561507200000",
    "number": "1104917079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 N MAIN ST",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484461350",
            "telephone_number": "810-667-5500",
            "fax_number": "810-342-1335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 N MAIN ST",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484461350",
            "telephone_number": "810-667-5500",
            "fax_number": "810-342-1335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLAREN LAPEER REGION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2019-06-26",
        "status": "A",
        "authorized_official_last_name": "KORTE",
        "authorized_official_first_name": "FRED",
        "authorized_official_title_or_position": "VP/CFO",
        "authorized_official_telephone_number": "810-342-2000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "09943",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPLUS OF MICHIGAN",
            "identifier": "0000004",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "13549",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "62 3407428",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lapeer, MI

Sources for this page

Verify at the official NPI Registry.