Samaritas

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

414021 Issued in MI

Legal business name

SAMARITAS

Doing business as

The Lodge at MapleCreek

Practice address

1950 32ND St SE
Grand Rapids, MI 49508-7909

Phone

(616) 452-5900

Fax

(616) 452-4271

NPI assigned

Aug 23, 2005

Last updated

Jan 25, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jenny Cederstrom

Title

Cfo

Phone

(313) 823-7700

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• The Lodge at MapleCreek Doing business as

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.

• Matthew Cesar Slendebroek, M.D.

  • Family Medicine Physician
  • Wyoming, MI
  • NPI 1942445945
  NPD (past)

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485302400000",
    "number": "1750374914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8131 E JEFFERSON AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482142610",
            "telephone_number": "313-823-7700",
            "fax_number": "313-823-9604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 32ND ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495087909",
            "telephone_number": "616-452-5900",
            "fax_number": "616-452-4271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMARITAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-23",
        "last_updated": "2017-01-25",
        "status": "A",
        "authorized_official_last_name": "CEDERSTROM",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "313-823-7700"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MI",
            "license": "414021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "09890",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2150464",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Lodge at MapleCreek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Renee K Salyer, P.A-C
• Emily Salzman, LMSW
• Soroush Rabiei Samani, MD
• Sonia Ajay Samant, MD
• Samaritas (The Woods at MapleCreek)
• Paige Elizabeth Sambor
• Amber Samons
• Angelia Roselynn Sams
• Cassandra Marie Sams, MD
• Samuel T. Bander, DDS, PLC (Bander Dental Group)

• Skilled Nursing Facility in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Skilled Nursing Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.