NPIMap

Organization Active NPI

Forest Health Medical Center LLC

Doing business as Forest Health Medical Center

  • General Acute Care Hospital
  • Ypsilanti, MI
National Provider Identifier
1669493664
Registry record updated Oct 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
FOREST HEALTH MEDICAL CENTER LLC
Doing business as
Forest Health Medical Center
Practice address
135 S Prospect St
Ypsilanti, MI 48198-7914
Phone
(734) 547-4722
Fax
(734) 547-1461
NPI assigned
Jul 22, 2006
Last updated
Oct 22, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2018

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

Authorized official

Name
Ej Ledesma
Title
President
Phone
(734) 547-1410

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X NU Primary
Pharmacy 333600000X NU
Institutional Pharmacy 3336I0012X 5301007213 MI
Specialty Pharmacy 3336S0011X NU
Compounding Pharmacy 3336C0004X NU

Addresses

Primary practice location

135 S Prospect St
Ypsilanti, MI 48198-7914

Mailing address

135 S Prospect St
Ypsilanti, MI 48198-7914
Phone (734) 547-4721

Other identifiers 2

IdentifierTypeStateIssuer
2135339OtherPK
304274504MedicaidMI

Other names 1

  • Forest Health Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050829001091 MI Part A Provider - Hospital 2264463207 Practice locations: Ypsilanti, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669493664. Details of each certification follow.

Hospital certification: CCN 230144

Legal name
FOREST HEALTH MEDICAL CENTER LLC
Doing business as
FOREST HEALTH MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
May 12, 2021
Beds
148
Ownership / control type
Hospital district or authority
Most recent change of ownership
May 31, 2000 (3 total)
Organization structure
CorporationProprietary
Enrollment address
135 S Prospect St
Ypsilanti, MI 48198-7914
Other Hospital Practice Location
Hospital subgroups
Acute care

Care Compare: Hospital

Medicare Care Compare
Listed as
Forest Health Medical CenterCCN 230144 · All quality measures
Type
Acute Care Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

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
23D0369390Forest Health Medical Center135 South Prospect Street, Ypsilanti, MI 48198AccreditationJan 22, 2028

National Provider Directory

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 8

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

NameRoleSinceShare
Chatham Capital Corp Organization, Ypsilanti, MI LLC 5% Or Greater Direct Ownership Interest Apr 7, 2000 53%
Robert a Brown Individual Corporate Director Dec 8, 2005
Randall L Pittman Individual Corporate Director Nov 28, 2005
Joann Scripko Individual W-2 Managing EmployeeManager Billing Dept Dec 15, 2013 5%
Elihu Ledesma Individual Corporate DirectorPresident Nov 28, 2005 50%
Laurence Henry Lenz Individual Corporate DirectorExecutive VP May 21, 2001 25%
W-2 Managing EmployeeExecutive VP Apr 29, 2013
Trevor J Dyksterhouse Individual Corporate Director Nov 28, 2005
FMHC Investors, LLC Organization, Ypsilanti, MI LLC 5% Or Greater Direct Ownership Interest Feb 9, 2010 47%

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 11

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": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540166400000",
    "number": "1669493664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 S PROSPECT ST",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481987914",
            "telephone_number": "734-547-4721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 S PROSPECT ST",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481987914",
            "telephone_number": "734-547-4722",
            "fax_number": "734-547-1461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREST HEALTH MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2018-10-22",
        "status": "A",
        "authorized_official_last_name": "LEDESMA",
        "authorized_official_first_name": "EJ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-547-1410"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "MI",
            "license": "5301007213",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2135339",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "304274504",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Forest Health Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Forest Health Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.