NPIMap

Organization Active NPI

Advisacare Solutions of Northern Michigan, LLC

  • Home Health Agency
  • Charlevoix, MI
National Provider Identifier
1659914810
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
ADVISACARE SOLUTIONS OF NORTHERN MICHIGAN, LLC
Practice address
218 W Garfield Ave
Charlevoix, MI 49720-1631
Phone
(231) 547-6092
Fax
(231) 508-8061
NPI assigned
Oct 21, 2019
Last updated
Feb 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Authorized official

Name
Kristian Skogen
Title
Ceo
Phone
(616) 464-1117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

218 W Garfield Ave
Charlevoix, MI 49720-1631

Mailing address

4234 Cascade Rd SE
Grand Rapids, MI 49546-8384
Phone (616) 464-1117

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200416003298 MI Part A Provider - Home Health Agency 9133553191 Practice locations: Charlevoix, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1659914810. Details of each certification follow.

Home health agency certification: CCN 237042

Legal name
ADVISACARE SOLUTIONS OF NORTHERN MICHIGAN, LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 24, 1967
Last certification
Jun 5, 2014
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Aug 20, 2019 in MI
Enrollment address
218 W Garfield Ave
Charlevoix, MI 49720-1631

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Advisacare Solutions of Northern Michigan, LLCCCN 237042 · All quality measures
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
Jan 24, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Advisacare Solutions of Northern Michigan LLC3 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.

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Kristian E Skogen Individual 5% Or Greater Indirect Ownership Interest Mar 6, 2020 100%
Corporate OfficerPresident, Board Member Mar 6, 2020
Corporate DirectorPresident, Board Member Mar 6, 2020
Advisacare Healthcare Solutions, Inc. Organization, Grand Rapids, MI Corporation, Medical provider/supplier, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Mar 6, 2020 100%
Lise' M Reigler Individual Corporate OfficerController, Board Member Mar 6, 2020
Corporate DirectorController, Board Member Mar 6, 2020
Jean a Pattee Individual W-2 Managing EmployeeAd; Feb 15, 2024

Owners & managing parties with NPI records 2

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

Facilities with the same owner 6

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

Change-of-ownership history 1

DateEventCounterparty
Mar 6, 2020 Change of OwnershipThis provider was the buyer Northwest Michigan Community Health AgencyCCN 237042, MI, NPI 1477502938

Practitioners & affiliated clinicians

Affiliated clinicians 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675728000000",
    "number": "1659914810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4234 CASCADE RD SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468384",
            "telephone_number": "616-464-1117",
            "fax_number": "616-464-1044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 W GARFIELD AVE",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201631",
            "telephone_number": "231-547-6092",
            "fax_number": "231-508-8061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVISACARE SOLUTIONS OF NORTHERN MICHIGAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-21",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A",
        "authorized_official_last_name": "SKOGEN",
        "authorized_official_first_name": "KRISTIAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "616-464-1117"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlevoix, MI

Sources for this page

Verify at the official NPI Registry.