NPIMap

Organization Active NPI

Spectrum Health Continuing Care

Doing business as Corewell Health Rehabilitation & Nursing Center - Kentridge

  • Skilled Nursing Facility
  • Grand Rapids, MI
National Provider Identifier
1750365532
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
414090 Issued in MI
Legal business name
SPECTRUM HEALTH CONTINUING CARE
Doing business as
Corewell Health Rehabilitation & Nursing Center - Kentridge
Spectrum Health Rehab & Nursing Center-Kalamazoo
Practice address
4118 Kalamazoo Ave SE
Grand Rapids, MI 49508-3605
Phone
(616) 455-7300
Fax
(616) 455-7154
NPI assigned
Dec 5, 2005
Last updated
Oct 3, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
SPECTRUM HEALTH CONTINUING CAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Authorized official

Name
Mr. Matthew E Cox
Title
Cfo
Phone
(616) 391-1663

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 414090 MI
Skilled Nursing Facility 314000000X 414090 MI Primary

Addresses

Primary practice location

4118 Kalamazoo Ave SE
Grand Rapids, MI 49508-3605

Mailing address

750 Fuller Ave NE
MC 160
Grand Rapids, MI 49503-1918
Phone (616) 643-9083

Other identifiers 2

IdentifierTypeStateIssuer
602154472MedicaidMI
09613OtherMIBCBS

Other names 2

  • Corewell Health Rehabilitation & Nursing Center - Kentridge Doing business as
  • Spectrum Health Rehab & Nursing Center-Kalamazoo Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040625000094 MI Part A Provider - Skilled Nursing Facility 1355327982 Practice locations: Grand Rapids, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1750365532. Details of each certification follow.

Skilled nursing facility certification: CCN 235035

Legal name
SPECTRUM HEALTH CONTINUING CARE
Doing business as
COREWELL HEALTH REHABILITATION & NURSING CENTER - KENTRIDGE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1967
Last certification
Aug 15, 2024
Beds
165
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Corewell Health
Organization structure
CorporationNon-profit
Incorporated
Jan 31, 1984 in MI
Enrollment address
4118 Kalamazoo Ave SE
Grand Rapids, MI 49508-3605
Nursing home name
COREWELL HEALTH REHABILITATION & NURSING CENTER - KENTRIDGE
Affiliated entity
COREWELL HEALTH

Care Compare: Nursing home

Medicare Care Compare
Listed as
Corewell Health Rehabilitation & Nursing Center -CCN 235035 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jan 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
165145.4 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
23D0380694Corewell Health Nursing and Rehabilitation4118 Kalamazoo Ave SE, Grand Rapids, MI 49508Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Part of
Elder Consult

Member of 1

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

Ownership & related parties

All disclosed owners & managing parties 19

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, CH Continuing Care Mar 1, 2013 100%
Adp of the SNF Mar 1, 2013
Christina Freese Decker Individual Corporate OfficerPresident & Ceo Corewell Health Aug 21, 2018
Adp of the SNF Jun 5, 2025
Michelle Boss Individual Operational/Managerial Control Jan 19, 2020
Adp of the SNF Jan 19, 2020
Talawnda L Bragg Individual Corporate DirectorBoard Member Jan 1, 2022
Christopher B Port Individual Corporate DirectorBoard Member Aug 18, 2020
Ronald M Hofman Individual Corporate DirectorBoard Member Aug 18, 2020
Annica Euurand Waalkes Individual Corporate DirectorBoard Member Aug 18, 2020
Matthew E Cox Individual Corporate OfficerChief Financial Officer Jul 1, 2022
Mark Wilson Individual Corporate DirectorBoard Member Aug 18, 2020
Corewell Health Organization, Grand Rapids, MI Corporation, Non-profit, Chain home office 5% Or Greater Direct Ownership Interest Jul 1, 1982 100%
Operational/Managerial Control Jul 1, 1982
Adp of the SNF Jul 1, 1982
Johannie M Torres Individual Corporate DirectorBoard Member Aug 18, 2020
Mary Doornbos Individual Corporate DirectorBoard Member Aug 18, 2020
John Buckley Individual Corporate DirectorBoard Member Aug 18, 2020
Sam R Watson Individual Corporate DirectorBoard Member Aug 18, 2020
Bill P Pink Individual Corporate DirectorBoard Member Aug 18, 2020
Simin Beg Individual Corporate DirectorBoard Member Aug 18, 2020
Lynnette Ferrell-Robinson Individual Corporate DirectorBoard Member Aug 18, 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 3

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 3

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": "1133740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696291200000",
    "number": "1750365532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 FULLER AVE NE",
            "address_2": "MC 160",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031918",
            "telephone_number": "616-643-9083",
            "fax_number": "616-643-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4118 KALAMAZOO AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495083605",
            "telephone_number": "616-455-7300",
            "fax_number": "616-455-7154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM HEALTH CONTINUING CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECTRUM HEALTH CONTINUING CARE",
        "enumeration_date": "2005-12-05",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A",
        "authorized_official_last_name": "COX",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "616-391-1663",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "MI",
            "license": "414090",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MI",
            "license": "414090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "602154472",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "09613",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corewell Health Rehabilitation & Nursing Center - Kentridge",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Spectrum Health Rehab & Nursing Center-Kalamazoo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.