NPIMap

Organization Active NPI

The Medical Team, Inc.

  • Community Based Hospice Care Agency
  • Flint, MI
National Provider Identifier
1679877211
Registry record updated Oct 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
1041000130 Issued in MI
Legal business name
THE MEDICAL TEAM, INC.
Practice address
5406 Gateway Ctre
Suite F
Flint, MI 48507-3933
Phone
(810) 239-3000
Fax
(810) 239-3650
NPI assigned
Dec 22, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2022

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

Authorized official

Name
Ryan Grisard
Title
Cfo
Phone
(703) 390-2300

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WH1000X
Community Based Hospice Care Agency 251G00000X 1041000130 MI Primary

Addresses

Primary practice location

5406 Gateway Ctre
Suite F
Flint, MI 48507-3933

Mailing address

4400 S Saginaw St Ste 1300a
Flint, MI 48507-2645
Phone (810) 239-3000

Other identifiers 1

IdentifierTypeStateIssuer
=========OtherMITAX ID

Other names 1

  • The Medical Team, Inc. Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131206001071 MI Part A Provider - Hospice 9638089972 Practice locations: Flint, MI

Hospice certification: CCN 231631

Legal name
THE MEDICAL TEAM, INC.
Certification status
Active
Provider type (POS)
Hospice
Participating since
Apr 17, 2014
Last certification
Mar 17, 2017
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Jun 2, 1983 in VA
Enrollment address
5406 Gateway Ctr
Ste F
Flint, MI 48507-3933

Other NPIs with the same Medicare PAC ID 11

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

Care Compare: Hospice

Medicare Care Compare
Listed as
The Medical TeamCCN 231631
Ownership
For-Profit
Certified
Apr 17, 2014
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
The Medical Team Inc23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

Member of 1

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

Locations

4400 S Saginaw St
Ste 1300A
Flint, MI 48507

5406 Gateway Ctr
Ste F
Flint, MI 48507
Phone (810) 239-3000

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Leslie Pembrook Individual 5% Or Greater Direct Ownership InterestPresident/Ceo Jun 2, 1983 100%
Corporate OfficerVice President/Ceo Jun 2, 1983 20%
Operational/Managerial Control Apr 17, 2014 100%
Ryan Grisard Individual Corporate OfficerChief Financial Officer May 1, 2015 20%
W-2 Managing Employee May 1, 2015 20%
Kim Marie Cox Individual W-2 Managing EmployeeAdministrator Dec 1, 2012 40%
Kristina V Nikolakeas Individual Contracted Managing EmployeeMD; Jan 9, 2017 20%
The Medical Team, Inc. Organization, Flint, MI Corporation, For-profit Operational/Managerial Control Apr 17, 2014 100%

Owners & managing parties with NPI records 12

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

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
The Medical Team, Inc.Grand Rapids, MI, CCN 231656 Hospice Operational/Managerial Control (100%) Jun 2, 1983
The Medical Team, Inc.Reston, VA, CCN 491623 Hospice Operational/Managerial Control (100%) Jun 2, 1983
The Medical Team, Inc.San Antonio, TX, CCN 741714 Hospice Operational/Managerial Control Jun 2, 1983

Owned or controlled facilities with NPI records 3

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

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Affiliated clinicians 7

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": "1292976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666310400000",
    "number": "1679877211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 S SAGINAW ST STE 1300A",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485072645",
            "telephone_number": "810-239-3000",
            "fax_number": "810-239-3650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5406 GATEWAY CTRE",
            "address_2": "SUITE F",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485073933",
            "telephone_number": "810-239-3000",
            "fax_number": "810-239-3650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MEDICAL TEAM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-22",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-14",
        "status": "A",
        "authorized_official_last_name": "GRISARD",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "703-390-2300"
    },
    "taxonomies": [
        {
            "code": "163WH1000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Hospice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "MI",
            "license": "1041000130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "=========",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Medical Team, Inc.",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "The Medical Team, Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.