Organization Active NPI

Munising Opco, LLC

Doing business as Medilodge of Munising

Skilled Nursing Facility
Munising, MI

National Provider Identifier

1497271795

Registry record updated Jul 21, 2022

On this page

Key facts
NPPES NPI Registry
Medicare participation
Care Compare: Nursing home
Laboratory certificates & supplier records
National Provider Directory
Ownership & related parties
Practitioners & affiliated clinicians
NPI Registry JSON
Other providers in Munising, MI
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name: MUNISING OPCO, LLC
Doing business as: Medilodge of Munising
Practice address: 300 City Park Dr
Munising, MI 49862-1130
Phone: (906) 387-2273
NPI assigned: Aug 17, 2017
Last updated: Jul 21, 2022By the provider in NPPES
Organization subpart: No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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)	Code	License	State	Primary
Skilled Nursing Facility	314000000X			Primary

Addresses

Primary practice location

300 City Park Dr
Munising, MI 49862-1130

Mailing address

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

Other practice location 1

300 City Park Dr
Munising, MI 49862-1130

Other names 1

Medilodge of Munising Doing business as

Medicare participation

Medicare enrollment files

Medicare fee-for-service enrollment: Enrolled in MI

Enrollment records 1

Enrollment ID	State	Provider type	PAC ID	Details
O20180213002136	MI	Part A Provider - Skilled Nursing Facility	5698035608	Practice locations: Munising, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1497271795. Details of each certification follow.

CCN 235410 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 235410

Legal name: MUNISING OPCO LLC
Doing business as: MEDILODGE OF MUNISING
Certification status: Active
Provider type (POS): Nursing home – SNF/NF distinct part
Participating since: Nov 1, 1980
Last certification: Oct 24, 2024
Beds: 90
Ownership / control type: Limited Liability Corporation
Multi-facility organization: Prestige Healthcare
Organization structure: LLCProprietary
Incorporated: Jul 25, 2017 in DE
Enrollment address: 300 City Park Dr
Munising, MI 49862-1130
Nursing home name: MEDILODGE OF MUNISING
Affiliated entity: MEDILODGE

Care Compare: Nursing home

Medicare Care Compare

Listed as: Medilodge of MunisingCCN 235410 · All quality measures
Overall star rating: 1 of 5
Health inspections: 1 of 5
Staffing: 3 of 5
Quality measures: 2 of 5
Type: Medicare and Medicaid
Ownership: For profit - Limited Liability company
Certified: Nov 1, 1980
Medicare certification status: ActiveFrom the Provider of Services file
Certified beds: 9073.2 residents per day on average
Chain: Medilodge53 facilities in the chain
Penalties (3 years): 2Fines totaling $84,659

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 number	Laboratory	Certificate	Expires
23D0382261	Munising Opco, LLC300 City Park Drive, Munising, MI 49862	Certificate of waiver	Aug 31, 2026

National Provider Directory

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.

Name	Role	Since	Share
Cody Healthcare S Corp Organization, Agoura Hills, CA Corporation, For-profit	5% Or Greater Indirect Ownership Interest	Feb 1, 2018	47.55%
B&Y Trust Organization, Brooklyn, NY	5% Or Greater Indirect Ownership Interest	Feb 1, 2018	47.55%
Prestige Administrative Services, LLC Organization, Louisville, KY LLC, Consulting firm, For-profit	Operational/Managerial Control	Feb 1, 2018
Blossom Healthcare Management LLC Organization, Louisville, KY LLC, Management services company, For-profit	Operational/Managerial Control	Feb 1, 2018
Craig a Flashner Individual	Corporate DirectorLLC Member / Governing Body	Feb 1, 2018
Craig a Flashner Individual	Operational/Managerial ControlLLC Member / Governing Body	Feb 1, 2018
Kristine Ranel Kirk Individual	W-2 Managing EmployeeBusiness Manager	Feb 1, 2018
Robert L Norcross Individual	Contracted Managing EmployeeCeo	Feb 1, 2018
Craig Flashner 2007 Trust Organization, Agoura Hills, CA	5% Or Greater Indirect Ownership Interest	Feb 1, 2018	47.55%
B&Y Healthcare S Corp Organization, Brooklyn, NY Corporation, For-profit	5% Or Greater Indirect Ownership Interest	Feb 1, 2018	47.55%
Stacey Paul Rogers Individual	Contracted Managing EmployeeCfo	Feb 1, 2018
Yitzchok a Perlstein Individual	Corporate DirectorLLC Member / Governing Body	Feb 1, 2018
Yitzchok a Perlstein Individual	Operational/Managerial ControlLLC Member / Governing Body	Feb 1, 2018
Everest Opco Group LLC Organization, Louisville, KY Created for acquisition, LLC, For-profit	5% Or Greater Direct Ownership Interest	Feb 1, 2018	100%

Facilities with the same owner 77

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

Alpena Opco LLC

dba Medilodge of Alpena
- Skilled Nursing Facility
- Alpena, MI
- NPI 1891211264
B&Y Healthcare S Corp, B&Y Trust, Blossom Healthcare Management LLC, Cody Healthcare S Corp, Craig Flashner 2007 Trust, Everest Opco Group LLC, Prestige Administrative Services, LLC
CMS ownership
Capital Area Opco LLC

dba Medilodge of Capital Area
- Skilled Nursing Facility
- Lansing, MI
- NPI 1528465739
B&Y Healthcare S Corp, B&Y Trust, Cody Healthcare S Corp, Craig Flashner 2007 Trust, Prestige Administrative Services, LLC
CMS ownership
Cass City Opco LLC

dba Medilodge of Cass City
- Skilled Nursing Facility
- Cass City, MI
- NPI 1316344526
B&Y Healthcare S Corp, B&Y Trust, Cody Healthcare S Corp, Craig Flashner 2007 Trust, Prestige Administrative Services, LLC
CMS ownership
Cheboygan Opco LLC

dba Medilodge of Cheboygan
- Skilled Nursing Facility
- Cheboygan, MI
- NPI 1295251676
B&Y Healthcare S Corp, B&Y Trust, Blossom Healthcare Management LLC, Cody Healthcare S Corp, Craig Flashner 2007 Trust, Everest Opco Group LLC, Prestige Administrative Services, LLC
CMS ownership
Clare Opco LLC

dba Medilodge of Clare
- Skilled Nursing Facility
- Clare, MI
- NPI 1659778868
B&Y Healthcare S Corp, B&Y Trust, Cody Healthcare S Corp, Craig Flashner 2007 Trust, Prestige Administrative Services, LLC
CMS ownership
East Lansing Opco LLC

dba Medilodge of Campus Area
- Skilled Nursing Facility
- East Lansing, MI
- NPI 1730546250
B&Y Healthcare S Corp, B&Y Trust, Cody Healthcare S Corp, Craig Flashner 2007 Trust, Prestige Administrative Services, LLC
CMS ownership
Farmington Opco LLC

dba Medilodge of Farmington
- Skilled Nursing Facility
- Farmington, MI
- NPI 1629442215
B&Y Healthcare S Corp, B&Y Trust, Cody Healthcare S Corp, Craig Flashner 2007 Trust
CMS ownership
Frankenmuth Opco, LLC

dba Medilodge of Frankenmuth
- Skilled Nursing Facility
- Frankenmuth, MI
- NPI 1427455641
B&Y Healthcare S Corp, B&Y Trust, Cody Healthcare S Corp, Craig Flashner 2007 Trust, Prestige Administrative Services, LLC
CMS ownership
Gaylord Opco, LLC

dba Medilodge of Gaylord
- Skilled Nursing Facility
- Gaylord, MI
- NPI 1215453691
B&Y Healthcare S Corp, B&Y Trust, Blossom Healthcare Management LLC, Cody Healthcare S Corp, Craig Flashner 2007 Trust, Everest Opco Group LLC, Prestige Administrative Services, LLC
CMS ownership
Grand Blanc Opco LLC

dba Medilodge of Grand Blanc
- Skilled Nursing Facility
- Grand Blanc, MI
- NPI 1790180255
B&Y Healthcare S Corp, B&Y Trust, Cody Healthcare S Corp, Craig Flashner 2007 Trust, Prestige Administrative Services, LLC
CMS ownership
Grand Haven Opco LLC

dba Medilodge at the Shore
- Skilled Nursing Facility
- Grand Haven, MI
- NPI 1770078263
B&Y Healthcare S Corp, B&Y Trust, Cody Healthcare S Corp, Craig Flashner 2007 Trust, Prestige Administrative Services, LLC
CMS ownership
Grand Rapids Opco, LLC

dba Medilodge of Grand Rapids
- Skilled Nursing Facility
- Grand Rapids, MI
- NPI 1083347660
B&Y Healthcare S Corp, B&Y Trust, Cody Healthcare S Corp, Craig Flashner 2007 Trust, Prestige Administrative Services, LLC
CMS ownership

View all 77

Practitioners & affiliated clinicians

Practitioners 2

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.

Paul Walter Haduck, DO
- Family Medicine Physician
- Munising, MI
- NPI 1679587174
NPD (past)
Stephanie Nicole Wuest, MD
- Family Medicine Physician
- Munising, MI
- NPI 1932330818
NPD (past)

Affiliated clinicians 3

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

Mark D Cecilio, MD
- Student in an Organized Health Care Education/Training Program
- Marquette, MI
- NPI 1487889903
Nursing home
Care Compare affiliation
Paul Walter Haduck, DO
- Family Medicine Physician
- Munising, MI
- NPI 1679587174
Nursing home
Care Compare affiliation
Stephanie Nicole Wuest, MD
- Family Medicine Physician
- Munising, MI
- NPI 1932330818
Nursing home
Care Compare affiliation

NPI Registry JSON

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

{
    "created_epoch": "1502928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1497271795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 NEW LA GRANGE RD STE 100",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224870",
            "telephone_number": "502-429-8062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CITY PARK DR",
            "city": "MUNISING",
            "state": "MI",
            "postal_code": "498621130",
            "telephone_number": "906-387-2273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 City Park Dr",
            "address_purpose": "LOCATION",
            "city": "Munising",
            "state": "MI",
            "postal_code": "498621130",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MUNISING OPCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-17",
        "last_updated": "2022-07-21",
        "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medilodge of Munising",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Munising, MI

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.