NPIMap

Organization Active NPI

Spectrum Health Hospitals

  • Skilled Nursing Facility
  • Grand Rapids, MI
National Provider Identifier
1689101784
Registry record updated May 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1070000195 Issued in MI
Legal business name
SPECTRUM HEALTH HOSPITALS
Practice address
1226 Cedar St NE
Grand Rapids, MI 49503-1370
Phone
(616) 486-3001
NPI assigned
May 19, 2017
Organization subpart
Yes
Parent organization
SPECTRUM HEALTH HOSPITALSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 24, 2024

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

Authorized official

Name
Matthew E Cox
Title
SVP, Finance SHHG
Phone
(616) 391-1663

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1070000195 MI Primary

Addresses

Primary practice location

1226 Cedar St NE
Grand Rapids, MI 49503-1370

Mailing address

100 Michigan St NE
Grand Rapids, MI 49503-2560
Phone (616) 643-9143

Other identifiers 1

IdentifierTypeStateIssuer
624151184MedicaidMI

Other names 2

  • Corewell Health Grand Rapids Hospitals - 1226 Cedar St Doing business as
  • Corewell Health Grand Rapids Hospitals Rehabilitation & Nursing Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170912003285 WI Part A Provider - Skilled Nursing Facility 8921904764 Practice locations: Grand Rapids, MI

Skilled nursing facility certification: CCN 235075

Legal name
SPECTRUM HEALTH HOSPITALS
Doing business as
COREWELL HEALTH GRAND RAPIDS HOSPITALS REHABILITATION & NURSING CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 3, 1967
Last certification
Nov 21, 2024
Beds
120
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Corewell Health
Organization structure
CorporationNon-profit
Incorporated
May 12, 1976 in MI
Enrollment address
1226 Cedar St NE
Grand Rapids, MI 49503-1370
Nursing home name
COREWELL HEALTH GRAND RAPIDS HOSPITALS REHABILITATION & NURSING CENTER
Affiliated entity
COREWELL HEALTH

Other NPIs with the same Medicare PAC ID 8

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Corewell Health Grand Rapids Hospitals RehabilitatCCN 235075
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jan 3, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
120114.7 residents per day on average
Chain
Corewell Health6 facilities in the chain

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 numberLaboratoryCertificateExpires
23D0907817Corewell Health Grand Rapids Hospitals1226 Cedar St NE, Grand Rapids, MI 49503Certificate of waiverOct 22, 2027

National Provider Directory

National Provider Directory
Tax ID family
Grand Rapids Pediatrics86 organizations share this tax ID, including this one
Part of
Grand Rapids Pediatrics

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1226 Cedar St NE
#845
Grand Rapids, MI 49503

1226 Cedar St NE
Grand Rapids, MI 49503
Phone (616) 267-4200

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Karen R Pakkala Individual Corporate OfficerPresident Continuing Care Services Sep 8, 2023 100%
Operational/Managerial Control Sep 8, 2023
Adp of the SNF Sep 8, 2023
Christina Freese Decker Individual Corporate OfficerPresident & Ceo Corewell Health Feb 1, 2022
Adp of the SNF Feb 1, 2022
Talawnda L Bragg Individual Corporate DirectorBoard Member Sep 26, 2021
Christopher B Port Individual Corporate DirectorBoard Member Mar 12, 2020
Ronald M Hofman Individual Corporate DirectorBoard Member Mar 12, 2020
Annica Euurand Waalkes Individual Corporate DirectorBoard Member Mar 12, 2020
Amy Sells Individual Operational/Managerial Control Aug 1, 2017
Adp of the SNF Aug 1, 2017
Matthew E Cox Individual Corporate OfficerCfo Jan 1, 2022
Mark Wilson Individual Corporate DirectorBoard Member Dec 11, 2024
Corewell Health Organization, Grand Rapids, MI Corporation, Non-profit, Chain home office 5% Or Greater Direct Ownership Interest Sep 23, 1997 100%
Adp of the SNF Apr 14, 2025
Johannie M Torres Individual Corporate DirectorBoard Member Mar 12, 2020
Mary Doornbos Individual Corporate DirectorBoard Member Mar 12, 2020
Praveen Thadani Individual Corporate DirectorBoard Member Jan 1, 2021
John Buckley Individual Corporate DirectorBoard Member Mar 12, 2020
Sam R Watson Individual Corporate DirectorBoard Member Mar 12, 2020
Bill P Pink Individual Corporate DirectorBoard Member Mar 12, 2020
Simin Beg Individual Corporate DirectorBoard Member Mar 12, 2020
Lynnette Ferrell-Robinson Individual Corporate DirectorBoard Member Mar 12, 2020
Iris F Boettcher Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
Tamila Marlow Individual Operational/Managerial Control Sep 1, 2020
Adp of the SNF Sep 1, 2020

Owners & managing parties with NPI records 6

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

Facilities with the same owner 66

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

View all 66

Practitioners & affiliated clinicians

Practitioners 163

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

View all 163

NPI Registry JSON

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

{
    "created_epoch": "1495152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716508800000",
    "number": "1689101784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-643-9143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1226 CEDAR ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031370",
            "telephone_number": "616-486-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM HEALTH HOSPITALS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECTRUM HEALTH HOSPITALS",
        "enumeration_date": "2017-05-19",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-20",
        "status": "A",
        "authorized_official_last_name": "COX",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "SVP, FINANCE SHHG",
        "authorized_official_telephone_number": "616-391-1663"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MI",
            "license": "1070000195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "624151184",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corewell Health Grand Rapids Hospitals - 1226 Cedar St",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Corewell Health Grand Rapids Hospitals - 1226 Cedar St",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Corewell Health Grand Rapids Hospitals Rehabilitation & Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.