Vista Grande Villa

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

384210 Issued in MI

Legal business name

VISTA GRANDE VILLA

Practice address

2251 Springport Rd
Jackson, MI 49202-1496

Phone

(517) 787-0222

Fax

(517) 787-6909

NPI assigned

Dec 5, 2005

Organization subpart

No

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

Authorized official

Name

Ms. Ellen A. Keatley

Title

President

Phone

(517) 787-0222

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Skilled nursing facility certification: CCN 235254

Legal name

VISTA GRANDE VILLA

Doing business as

VISTA GRANDE VILLA

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF distinct part

Participating since

Jan 15, 1976

Last certification

Nov 22, 2024

Beds

60

Ownership / control type

Nonprofit Corporation

Organization structure

CorporationNon-profit

Incorporated

Feb 13, 1970 in MI

Enrollment address

2251 Springport Rd
Jackson, MI 49202-1496

Nursing home name

VISTA GRANDE VILLA

Listed as

Vista Grande VillaCCN 235254

Overall star rating

4 of 5

Health inspections

3 of 5

Staffing

3 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Jan 15, 1976

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

6042.8 residents per day on average

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

All disclosed owners & managing parties 6

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

Practitioners 1

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

• Nicholas Maximillian Kielhorn, M.D.

  • Family Medicine Physician
  • Jackson, MI
  • NPI 1821240128
  NPD (past)

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Matthew Samuels Basham, NP-C

  • Nurse Practitioner
  • Saginaw, MI
  • NPI 1730719139

  Nursing home

  Care Compare affiliation
• Sana Chams

  • Geriatric Medicine (Internal Medicine) Physician
  • Jackson, MI
  • NPI 1730531146

  Nursing home

  Care Compare affiliation
• Nicholas Maximillian Kielhorn, M.D.

  • Family Medicine Physician
  • Jackson, MI
  • NPI 1821240128

  Nursing home

  Care Compare affiliation
• Jacob Sinkoff, D.O.

  • Emergency Medicine Physician
  • Jackson, MI
  • NPI 1801232434

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322524800000",
    "number": "1477537397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2251 SPRINGPORT RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492021496",
            "telephone_number": "517-787-0222",
            "fax_number": "517-787-6909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2251 SPRINGPORT RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492021496",
            "telephone_number": "517-787-0222",
            "fax_number": "517-787-6909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA GRANDE VILLA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-05",
        "last_updated": "2011-11-29",
        "status": "A",
        "authorized_official_last_name": "KEATLEY",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "517-787-0222",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MI",
            "license": "384210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SH. OF MI",
            "identifier": "09716",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2081106",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Courtney Marie Vincent, LLMSW
• Seth Vincent
• Dana Therese Virgo, M.D.
• Gurpinderjit Virk, MD
• Visiting Doctors PC
• Sarah Vlnka, LMSW
• Annalise Clare Vogel
• Emily Vogel, LMSW
• Darrin M Voris
• Ashley Voss

• Skilled Nursing Facility in Jackson, MI
• Providers in Jackson, MI by specialty
• Skilled Nursing Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.