Organization Active NPI

Richmond Opco LLC

  • Skilled Nursing Facility
  • Richmond, MI
National Provider Identifier
1316388622
Registry record updated Dec 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
RICHMOND OPCO LLC
Doing business as
MEDILODGE OF RICHMOND
Practice address
34901 Division Rd
Richmond, MI 48062-1559
Phone
(586) 727-7562
Fax
(586) 727-4091
NPI assigned
Jul 15, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2014

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

Authorized official

Name
Mr. Stacey Paul Rogers
Title
Chief Financial Officer
Phone
(502) 429-8062

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

34901 Division Rd
Richmond, MI 48062-1559

Mailing address

7400 New la Grange Rd
Suite 100
Louisville, KY 40222-4870
Phone (502) 429-8062

Other identifiers 1

IdentifierTypeStateIssuer
1316388622MedicaidMI

Other names 1

  • MEDILODGE OF RICHMOND Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130823000752 MI Part A Provider - Skilled Nursing Facility 9032352083 Practice locations: Richmond, MI

Skilled nursing facility certification: CCN 235486

Legal name
RICHMOND OPCO LLC
Doing business as
MEDILODGE OF RICHMOND
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Mar 6, 1989
Last certification
Jun 13, 2024
Beds
126
Ownership / control type
Corporation
Multi-facility organization
Prestige management
Organization structure
LLCProprietary
Incorporated
Jun 13, 2013 in DE
Enrollment address
34901 Division Rd
Richmond, MI 48062-1559
Nursing home name
MEDILODGE OF RICHMOND
Affiliated entity
MEDILODGE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Medilodge of RichmondCCN 235486 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Mar 6, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
126119.3 residents per day on average
Chain
Medilodge53 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0879018Richmond Opco, LLC34901 Division Rd, Richmond, MI 48062Certificate of waiverNov 8, 2027

National Provider Directory

National Provider Directory
Tax ID family
Medilodge of Richmond2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

34901 Division Rd
Rm 708
Richmond, MI 48062

34901 Division Rd
Richmond, MI 48062
Phone (586) 727-7562

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
Fifteeninone Opco Group LLC Organization, Westlake Village, CA Created for acquisition, LLC, For-profit 5% Or Greater Direct Ownership Interest Jun 24, 2013 100%
Cody Healthcare S Corp Organization, Westlake Village, CA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Jun 24, 2013 47.55%
B&Y Trust Organization, Brooklyn, NY 5% Or Greater Indirect Ownership Interest Jun 24, 2013 47.55%
Prestige Administrative Services, LLC Organization, Louisville, KY LLC, Consulting firm, For-profit Operational/Managerial Control Jan 1, 2016
Craig a Flashner Individual Operational/Managerial ControlLLC Manager Jun 24, 2013
Kristine Ranel Kirk Individual W-2 Managing EmployeeRegulatory Analyst Jan 1, 2018
Robert L Norcross Individual Contracted Managing EmployeeChief Executive Officer Jun 24, 2013
Craig Flashner 2007 Trust Organization, Westlake Village, CA 5% Or Greater Indirect Ownership Interest Jun 24, 2013 47.55%
B&Y Healthcare S Corp Organization, Brooklyn, NY Corporation, For-profit 5% Or Greater Indirect Ownership Interest Jun 24, 2013 47.55%
Generations Healthcare Management LLC Organization, Louisville, KY LLC, Management services company, For-profit Operational/Managerial Control Jun 24, 2013
Stacey Paul Rogers Individual Contracted Managing EmployeeChief Financial Officer Oct 20, 2014
Yitzchok a Perlstein Individual Operational/Managerial ControlLLC Manager Jun 24, 2013

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 2

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": "1373846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419897600000",
    "number": "1316388622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 NEW LA GRANGE RD",
            "address_2": "SUITE 100",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224870",
            "telephone_number": "502-429-8062",
            "fax_number": "502-429-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34901 DIVISION RD",
            "city": "RICHMOND",
            "state": "MI",
            "postal_code": "480621559",
            "telephone_number": "586-727-7562",
            "fax_number": "586-727-4091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHMOND OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-15",
        "last_updated": "2014-12-30",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "502-429-8062",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316388622",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDILODGE OF RICHMOND",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Richmond, MI

Sources for this page

Verify at the official NPI Registry.