NPIMap

Organization Active NPI

State of Michigan Office of Financial Management

Doing business as Caro Psychiatric Hospital

  • Psychiatric Hospital
  • Caro, MI
National Provider Identifier
1194767996
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
STATE OF MICHIGAN OFFICE OF FINANCIAL MANAGEMENT
Doing business as
Caro Psychiatric Hospital
Practice address
2040 Chambers Rd
Caro, MI 48723
Phone
(989) 672-9261
Fax
(989) 673-6749
NPI assigned
Jun 13, 2006
Last updated
Feb 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Authorized official

Name
Jeffery Wieferich
Title
Senior Executive
Phone
(517) 335-0499

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X NU Primary
Pharmacy 333600000X NU
Long Term Care Pharmacy 3336L0003X 5301000559 MI

Addresses

Primary practice location

2040 Chambers Rd
Caro, MI 48723

Mailing address

PO Box 30437
Lansing, MI 48909-7937
Phone (517) 241-5544

Other identifiers 2

IdentifierTypeStateIssuer
2040745OtherPK
1758845MedicaidMI

Other names 1

  • Caro Psychiatric Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040114000603 MI Part B Supplier - Clinic/Group Practice 5496650723 Receives reassigned benefits from 101 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kalamazoo, MI; Westland, MI; Marquette, MI; Caro, MI
O20040805000072 MI Part A Provider - Hospital 5496650723 Practice locations: Caro, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194767996. Details of each certification follow.

Hospital certification: CCN 234025

Legal name
STATE OF MICHIGAN OFFICE OF FINANCIAL MANAGEMENT
Doing business as
CARO PSYCHIATRIC HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Nov 11, 1984
Last certification
Sep 11, 2019
Beds
208 (205 certified)
Ownership / control type
State
Organization structure
GovernmentNon-profit
Incorporated
Jun 14, 1914 in MI
Enrollment address
2040 Chambers Rd
Caro, MI 48723-9240
Main/Primary Hospital Location
Hospital subgroups
General

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Caro Psychiatric HospitalCCN 234025 · All quality measures
Type
Psychiatric
Ownership
Government - State
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Kalamazoo Reg Psych Hos15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Locations

2000 Chambers Rd
Caro, MI 48723
Phone (517) 673-3191

2040 Chambers Rd
Caro, MI 48723
Phone (989) 672-9338

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
State of Michigan Office of Financial Management Organization, Caro, MI 5% Or Greater Direct Ownership Interest Jun 14, 1966 100%
5% Or Greater Security Interest Jun 14, 1966 100%
Operational/Managerial Control May 6, 2015 100%
Paula Kruse Individual Corporate DirectorActing Hospital Director Jan 30, 2024 100%
Operational/Managerial ControlActing Hospital Director Jan 30, 2024 100%

Owners & managing parties with NPI records 7

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

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Walter P Reuther Psychiatric HospitalWestland, MI, CCN 234035 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Nov 17, 1992
Dec 2, 2015
Kalamazoo Psychiatric HospitalKalamazoo, MI, CCN 234026 Hospital 5% Or Greater Direct Ownership Interest (100%)
5% Or Greater Security Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 1966
Jan 1, 1966
May 6, 2015
Center for Forensic PsychiatrySaline, MI, CCN 234041 Hospital 5% Or Greater Direct Ownership Interest (100%) Aug 6, 1975
DJ Jacobetti Home for VeteransMarquette, MI, CCN 235724 Skilled nursing facility Operational/Managerial Control (100%)
Adp of the SNF		 Jan 1, 1981
Jan 1, 1981
Department of Military & Veteran AffairsChesterfield, MI, CCN 235728 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 1, 2019
Mar 1, 2019
Department of Military & Veteran AffairsGrand Rapids, MI, CCN 235729 Skilled nursing facility Operational/Managerial Control (100%)
Adp of the SNF		 May 17, 2021
Jan 1, 1885

Owned or controlled facilities with NPI records 7

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 6

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

Practitioners & affiliated clinicians

Practitioners 118

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.

View all 118

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709078400000",
    "number": "1194767996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30437",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489097937",
            "telephone_number": "517-241-5544",
            "fax_number": "517-335-6995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 CHAMBERS RD",
            "city": "CARO",
            "state": "MI",
            "postal_code": "48723",
            "telephone_number": "989-672-9261",
            "fax_number": "989-673-6749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF MICHIGAN OFFICE OF FINANCIAL MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A",
        "authorized_official_last_name": "WIEFERICH",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_title_or_position": "SENIOR EXECUTIVE",
        "authorized_official_telephone_number": "517-335-0499"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "MI",
            "license": "5301000559",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2040745",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1758845",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Caro Psychiatric Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Caro, MI

Sources for this page

Verify at the official NPI Registry.