Mary Free Bed Rehabilitation Hospital
Organization Active NPI Rehabilitation Hospital · Grand Rapids, MI
NPI 1730133463 · NPPES record last updated Jan 27, 2022
Key facts
- NPI
- 1730133463
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rehabilitation Hospital 283X00000X
- License
- 410070 (MI)
- Legal business name
- MARY FREE BED REHABILITATION HOSPITAL
- Practice address
- 235 Wealthy SE
Grand Rapids, MI 49503-5299 - Phone
- (616) 242-0403
- Fax
- (616) 242-9113
- NPI assigned
- May 19, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Ryan Podvin
- Title
- Cfo
- Phone
- (616) 840-8676
Owners & managing parties with NPI records 2
-
Michael Thomas Andary, M.D.
-
Michael S Jakubowski, M.D.
Owned or controlled facilities with NPI records 4
Other NPIs on the same Medicare enrollment 3
Member organizations 7
Practitioners 245
-
Hiroshi Aida, MD
-
Tracey Allers, DPT
-
Kimberly B Augenstein, M.D.
-
Elizabeth J. Bachler, CNP
-
Philip Baty, MD
-
Brooke Diane Belanger, ANP-BC
-
Katherine Rose Bellesheim, PH.D.
-
Beth Joy Blackbird, PSYD
-
Anthony G Bonita, PHD
-
Barent Bradt, DO
-
Tiffany Nicole Broering-Robbins, DPT, MA
-
Sarah Brokaw, PT
-
Mara S Brown, NURSE PRACTITIONER
-
Benjamin J Bruinsma, M.D.
-
Paul Callaghan, PSYD
-
Nathan Carlton, MD
-
Edmund Hunt Chadd, M.D.
-
Julie Chestnut, PT, DPT
Affiliated clinicians 123
-
Shahnaz Ali, M.D.
-
Amy Jo Arends, NP-C
-
Alexander Armada, D.O.
-
Gregory James Artz, M.D.
-
Alison Aubry, NP
-
Elizabeth J. Bachler, CNP
-
Philip Baty, MD
-
Maraya Baumanis, MD
-
Andrew M. Behler, D.O.,M.P.H.
-
Jessica Ann Bertalan, PA-C
-
Piyush Bhatnagar, M.D.
-
Beth Joy Blackbird, PSYD
-
Anthony G Bonita, PHD
-
Benjamin J Bruinsma, M.D.
-
Jordan Cantor, DO
-
Nathan Carlton, MD
Medicare Care Compare: Inpatient rehabilitation facility
- Listed as
- Mary Free Bed Rehabilitation Hospital
- Ownership
- Non-profit
- Certified
- May 16, 1984
- Medicare certification status
- Active
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MI
Hospital certification: CCN 233026
- Legal name
- MARY FREE BED REHABILITATION HOSPITAL
- Doing business as
- MARY FREE BED REHABILITATION HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Rehabilitation
- Participating since
- May 16, 1984
- Last certification
- Mar 11, 2009
- Beds
- 167
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation · Non-profit
- Incorporated
- Mar 21, 1913 in MI
- Enrollment address
- 235 Wealthy St SE
Grand Rapids, MI 49503-5247 - Hospital subgroups
- Rehabilitation
All disclosed owners & managing parties 31
| Name | Role | Since | Share |
|---|---|---|---|
| Mary Free Bed Guild of Grand Rapids Michigan |
5% Or Greater Direct Ownership Interest | Dec 3, 1985 | 100% |
| Jeanne Skilton |
Corporate Director | Sep 26, 2017 | |
| Michael S Jakubowski |
Corporate Director | Aug 3, 2012 | |
| Gregory S Conway |
Corporate Director | Nov 22, 2011 | |
| James Moyer |
Corporate Director | Dec 15, 2011 | |
| Chad Bush |
Corporate Director | Jul 1, 2010 | |
| Judy Tamer |
W-2 Managing Employee |
Jan 4, 2021 | |
| Leanne Dimartino |
W-2 Managing Employee |
May 17, 2021 | |
| Michael B Williams |
Corporate Director | Nov 22, 2011 | |
| Bruce Brasser |
W-2 Managing Employee | Oct 7, 2002 | |
| David Muir |
Corporate Director | Jul 1, 2010 | |
| Nathaniel Guzman |
Corporate Officer |
Apr 1, 2021 | |
| Ellen Nelson |
Corporate Director | Sep 26, 2017 | |
| Michael T Andary |
Corporate Director | Jun 1, 2013 | |
| Susan Ellen Shannon |
W-2 Managing Employee |
Dec 1, 2017 | |
| Susan Taylor |
Corporate Director |
Aug 26, 2014 | |
| Kimberly Ridings |
Corporate Director | Jul 1, 2010 | |
| Margaret Nault |
Corporate Director | Sep 26, 2017 | |
| Judy Dunten |
Corporate Director | Sep 26, 2017 | |
| Laura L Puff |
Corporate Director | Sep 26, 2017 | |
| Carol M Springer |
Corporate Director |
Aug 26, 2014 | |
| Julie M Ridenour |
Corporate Director | Feb 24, 2006 | |
| Kent R Riddle |
Corporate Director | Feb 24, 2006 | |
| Scott Lewis |
Corporate Director | Sep 26, 2017 | |
| Roger W Spoelman |
Corporate Director |
Jun 1, 2013 | |
| Ingrid Cheslek |
Corporate Director | Sep 26, 2017 | |
| Dianne Deroseau |
Corporate Director | Sep 26, 2017 | |
| Molly Krauss |
Corporate Director | Jul 1, 2010 | |
| Holly Marie Peterson |
Corporate Director | Sep 26, 2017 | |
| Ryan T Podvin |
Corporate Director |
Apr 1, 2021 | |
| Michele L Suchovsky |
Corporate Director | Sep 26, 2017 |
All facility ownership & control disclosures 4
| Facility | Type | Role | Since |
|---|---|---|---|
| The Carle Foundation Hospital |
Hospital | Operational/Managerial Control | Nov 7, 2025 |
| Carle Bromenn Medical Center |
Hospital | Operational/Managerial Control | Nov 7, 2025 |
| Mary Free Bed Sub-Acute Rehabilitation |
Skilled nursing facility | 5% Or Greater Indirect Ownership Interest (50%) | Jul 1, 2015 |
| Mary Free Bed at Home, LLC |
Home health agency | 5% Or Greater Indirect Ownership Interest (60%) | Jun 1, 2016 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040116000604 | MI | Part B Supplier - Clinic/Group Practice | 4587576541 |
Receives reassigned benefits from 215 practitioners 3 other NPIs on this enrollment Practice locations: Traverse City, MI; Wyoming, MI; Saginaw, MI; Norton Shores, MI; Kalamazoo, MI; Holland, MI; Grand Rapids, MI; Elk Rapids, MI |
| O20060224000705 | MI | Part a Provider - Hospital | 4587576541 | Practice locations: Grand Rapids, MI; Wyoming, MI; Norton Shores, MI; Holland, MI |
National Provider Directory
Locations
350 Lafayette Ave SE
Grand Rapids, MI 49503
Phone (616) 235-3984
412 Plymouth Ave NE
Ste 412
Grand Rapids, MI 49505
Phone (616) 840-8126
1787 Grand Ridge Ct NE
Ste 204
Grand Rapids, MI 49525
Phone (616) 447-8725
1550 3 Mile Rd NW
Ste C
Grand Rapids, MI 49544
Phone (616) 727-7478
3700 Silver Lake Rd
Traverse City, MI 49684
Phone (231) 421-1599
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Hospital | 283X00000X | 410070 | MI | Yes |
Addresses
Primary practice location
235 Wealthy SE
Grand Rapids, MI 49503-5299
Mailing address
235 Wealthy SE
Grand Rapids, MI 49503-5299
Phone (616) 840-8676
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 233026 | Other | OSCAR | |
| 101556008 | Medicaid | MI | |
| 3996 | Other | PRIORITY HEALTH |
Other names
- Mary Free Bed Rehabilitation Hospital
Other providers in Grand Rapids, MI
- Mary Free Bed Rehabilitaiton Hospital
- Mary Free Bed Rehabilitation Hospital
- Mary Free Bed Rehabilitation Hospital
- Mary Free Bed Rehabilitation Hospital
- Mary Free Bed Rehabilitation Hospital
- Mary Free Bed Rehabilitation Hosptial
- Mary Free Bed Rehabilitation, LLC
- Mary Free Bed Rehabiltation Hospital
- Mary Free Bed Sub-Acute Rehabilitation
- Mary Laframboise
All providers in Grand Rapids, MI · Rehabilitation Hospital in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.