NPIMap

Organization Active NPI

Porter Hills Presbyterian Village, Inc.

Doing business as Porter Hills

  • Skilled Nursing Facility
  • Grand Rapids, MI
National Provider Identifier
1396975546
Registry record updated Feb 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PORTER HILLS PRESBYTERIAN VILLAGE, INC.
Doing business as
Porter Hills
Valley Health Center
Practice address
1029 E Paris Ave SE
Grand Rapids, MI 49546-3603
Phone
(616) 301-6209
NPI assigned
Jul 22, 2009
Last updated
Feb 16, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2026

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

Authorized official

Name
Nicole Lynn Maag
Title
Chief of Residential Services
Phone
(616) 460-9441

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

1029 E Paris Ave SE
Grand Rapids, MI 49546-3603

Mailing address

3600 Fulton St E
Grand Rapids, MI 49546-1322
Phone (616) 949-4971

Other names 2

  • Porter Hills Doing business as
  • Valley Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090812000945 MI Part A Provider - Skilled Nursing Facility 9234178740 Practice locations: Grand Rapids, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396975546. Details of each certification follow.

Skilled nursing facility certification: CCN 235649

Legal name
PORTER HILLS PRESBYTERIAN VILLAGE, INC.
Doing business as
VALLEY HEALTH CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 30, 2009
Last certification
Aug 8, 2024
Beds
20
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Brio Living Services
Organization structure
CorporationNon-profit
Enrollment address
1029 E Paris Ave SE
Grand Rapids, MI 49546-3603
Nursing home name
VALLEY HEALTH CENTER

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Valley Health CenterCCN 235649 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
5 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Oct 30, 2009
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
2019.1 residents per day on average

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
23D2320818Valley Health Center1029 E Paris Avenue, Grand Rapids, MI 49546Certificate of waiverMar 24, 2027

National Provider Directory

National Provider Directory
Tax ID family
Porter Hills Presbyterian Village Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 7

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

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Kalen Carlson Individual Operational/Managerial Control Jan 1, 2024
Adp of the SNF Jan 1, 2024
Harlem Russel Ives Individual Corporate Officer Jul 1, 2024
Trisha Watkins Individual Operational/Managerial Control Feb 19, 2019
Adp of the SNF Feb 19, 2019
Michael H. Fritz Individual Corporate OfficerBoard Member Mar 1, 2019
United Methodist Retirement Communities, Inc. Organization, Chelsea, MI Corporation, Non-profit 5% Or Greater Direct Ownership Interest Mar 1, 2019 100%
John Nixon Individual Corporate OfficerBoard Member Mar 1, 2019
Stephen P Fetyko Individual Corporate DirectorCeo Mar 1, 2019
Operational/Managerial Control Mar 1, 2019
Trustee of the SNF Mar 1, 2019
Adp of the SNF Mar 1, 2019
Nicole Maag Individual Operational/Managerial Control Mar 1, 2019
Trustee of the SNF Mar 1, 2019
Adp of the SNF Mar 1, 2019
Iris F Boettcher Individual Operational/Managerial Control May 13, 2013
Adp of the SNF May 13, 2013
Cheryl Van Bemden Individual Operational/Managerial Control Oct 30, 2014
Adp of the SNF Jan 30, 2014

Owners & managing parties with NPI records 2

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Emmanuel HospiceGrand Rapids, MI, CCN 231629 Hospice 5% Or Greater Direct Ownership Interest (18%) Feb 2, 2012

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Practitioners 1

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.

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": "1248220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771200000000",
    "number": "1396975546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 FULTON ST E",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495461322",
            "telephone_number": "616-949-4971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1029 E PARIS AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463603",
            "telephone_number": "616-301-6209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTER HILLS PRESBYTERIAN VILLAGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-22",
        "last_updated": "2026-02-16",
        "certification_date": "2026-02-16",
        "status": "A",
        "authorized_official_last_name": "MAAG",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CHIEF OF RESIDENTIAL SERVICES",
        "authorized_official_telephone_number": "616-460-9441"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Porter Hills",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Valley Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.