Extended Care at Fremont, LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

EXTENDED CARE AT FREMONT, LLC

Doing business as

Extended Care At Fremont

Practice address

54 Fremont St
Battle Creek, MI 49017-3831

Phone

(419) 494-4008

NPI assigned

Nov 15, 2022

Organization subpart

No

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

Authorized official

Name

Steven Gerdeman

Title

Ceo

Phone

(419) 494-4008

Specialties & licenses 1

Addresses

Other names 1

• Extended Care At Fremont Doing business as

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

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668470400000",
    "number": "1255040515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 TAMARACK AVE NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495044348",
            "telephone_number": "194-944-0084",
            "fax_number": "616-317-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 FREMONT ST",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490173831",
            "telephone_number": "419-494-4008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTENDED CARE AT FREMONT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-15",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A",
        "authorized_official_last_name": "GERDEMAN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "419-494-4008"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Extended Care At Fremont",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Josephine Pineda Evangelista, PT, DPT
• Renee Evans
• Danielle Marie Everett, RN
• Laura Everett, PT
• Margaret Everett
• Eyemart Express LLC
• Suzanne Marie Fabeck-Sims
• Elizabeth Grace Facey, RN
• Whitney Fairchild
• Ann Falin

• Adult Care Home Facility in Battle Creek, MI
• Providers in Battle Creek, MI by specialty
• Adult Care Home Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; 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.