Active NPI
Grand Blanc Opco LLC
Doing business as Medilodge of Grand Blanc
- Skilled Nursing Facility
- Grand Blanc, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- GRAND BLANC OPCO LLC
- Doing business as
- Medilodge of Grand Blanc
- Practice address
- 11941 Belsay Rd
Grand Blanc, MI 48439-1702 - Phone
- (810) 694-1970
- Fax
- (810) 694-4081
- NPI assigned
- Oct 27, 2014
- Last updated
- Jul 1, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Stacey Paul Rogers
- Title
- Chief Financial Officer
- Phone
- (502) 429-0650
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | NU | Primary |
Addresses
Primary practice location
11941 Belsay Rd
Grand Blanc, MI 48439-1702
Mailing address
7400 New la Grange Rd Ste 400
Louisville, KY 40222-4870
Phone (502) 429-8062
Other names 1
- Medilodge of Grand Blanc
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150106001631 | MI | Part A Provider - Skilled Nursing Facility | 9436472073 | Practice locations: Grand Blanc, MI |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1790180255. Details of each certification follow.
Skilled nursing facility certification: CCN 235226
- Legal name
- GRAND BLANC OPCO, LLC
- Doing business as
- MEDILODGE OF GRAND BLANC
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Oct 1, 1973
- Last certification
- Jan 14, 2025
- Beds
- 146
- Ownership / control type
- Corporation
- Multi-facility organization
- Prestige Healthcare
- Organization structure
- LLC
- Incorporated
- May 9, 2014 in DE
- Enrollment address
- 11941 Belsay Rd
Grand Blanc, MI 48439-1702 - Nursing home name
- MEDILODGE OF GRAND BLANC
- Affiliated entity
- MEDILODGE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Medilodge of Grand Blanc
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Oct 1, 1973
- Medicare certification status
- Active
- Certified beds
- 146
- Chain
- Medilodge
National Provider Directory
National Provider Directory- Tax ID family
- Grand Blanc Opco LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Medilodge of Grand Blanc
- Skilled Nursing Facility
- Grand Blanc, MI
- NPI 1609273648
Ownership & related parties
All disclosed owners & managing parties 11
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Cody Healthcare S Corp | 5% Or Greater Direct Ownership Interest | Feb 1, 2015 | 47.55% |
| B&Y Trust | 5% Or Greater Indirect Ownership Interest | Feb 1, 2015 | 47.55% |
| Prestige Administrative Services, LLC | Operational/Managerial Control | Jan 1, 2016 | |
| Craig a Flashner | Corporate Officer | Feb 1, 2015 | |
| Operational/Managerial Control | Feb 1, 2015 | ||
| Kristine Ranel Kirk | W-2 Managing Employee | Sep 1, 2016 | |
| Robert L Norcross | Contracted Managing Employee | Feb 1, 2015 | |
| Craig Flashner 2007 Trust | 5% Or Greater Indirect Ownership Interest | Feb 1, 2015 | 47.55% |
| B&Y Healthcare S Corp | 5% Or Greater Direct Ownership Interest | Feb 1, 2015 | 47.55% |
| Generations Healthcare Management LLC | Operational/Managerial Control | Apr 1, 2015 | |
| Stacey Paul Rogers | Contracted Managing Employee | Feb 1, 2015 | |
| Yitzchok a Perlstein | Corporate Officer | Feb 1, 2015 | |
| Operational/Managerial Control | Feb 1, 2015 |
Facilities with the same owner 77
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Medilodge of Alpena
- Skilled Nursing Facility
- Alpena, MI
- NPI 1891211264
B&Y Healthcare S Corp, B&Y Trust, Cody Healthcare S Corp, Craig Flashner 2007 Trust, Prestige Administrative Services, LLC
-
dba Medilodge of Capital Area
- Skilled Nursing Facility
- Lansing, MI
- NPI 1528465739
B&Y Healthcare S Corp, B&Y Trust, Cody Healthcare S Corp, Craig Flashner 2007 Trust, Prestige Administrative Services, LLC
-
dba Medilodge of Cass City
- Skilled Nursing Facility
- Cass City, MI
- NPI 1316344526
B&Y Healthcare S Corp, B&Y Trust, Cody Healthcare S Corp, Craig Flashner 2007 Trust, Prestige Administrative Services, LLC
-
dba Medilodge of Cheboygan
- Skilled Nursing Facility
- Cheboygan, MI
- NPI 1295251676
B&Y Healthcare S Corp, B&Y Trust, Cody Healthcare S Corp, Craig Flashner 2007 Trust, Prestige Administrative Services, LLC
-
dba Medilodge of Clare
- Skilled Nursing Facility
- Clare, MI
- NPI 1659778868
B&Y Healthcare S Corp, B&Y Trust, Cody Healthcare S Corp, Craig Flashner 2007 Trust, Prestige Administrative Services, LLC
-
dba Medilodge of Campus Area
- Skilled Nursing Facility
- East Lansing, MI
- NPI 1730546250
B&Y Healthcare S Corp, B&Y Trust, Cody Healthcare S Corp, Craig Flashner 2007 Trust, Prestige Administrative Services, LLC
-
dba Medilodge of Farmington
- Skilled Nursing Facility
- Farmington, MI
- NPI 1629442215
B&Y Healthcare S Corp, B&Y Trust, Cody Healthcare S Corp, Craig Flashner 2007 Trust
-
dba Medilodge of Frankenmuth
- Skilled Nursing Facility
- Frankenmuth, MI
- NPI 1427455641
B&Y Healthcare S Corp, B&Y Trust, Cody Healthcare S Corp, Craig Flashner 2007 Trust, Prestige Administrative Services, LLC
-
dba Medilodge of Gaylord
- Skilled Nursing Facility
- Gaylord, MI
- NPI 1215453691
B&Y Healthcare S Corp, B&Y Trust, Cody Healthcare S Corp, Craig Flashner 2007 Trust, Prestige Administrative Services, LLC
-
dba Medilodge at the Shore
- Skilled Nursing Facility
- Grand Haven, MI
- NPI 1770078263
B&Y Healthcare S Corp, B&Y Trust, Cody Healthcare S Corp, Craig Flashner 2007 Trust, Prestige Administrative Services, LLC
-
dba Medilodge of Grand Rapids
- Skilled Nursing Facility
- Grand Rapids, MI
- NPI 1083347660
B&Y Healthcare S Corp, B&Y Trust, Cody Healthcare S Corp, Craig Flashner 2007 Trust, Prestige Administrative Services, LLC
-
dba Medilodge of Green View
- Skilled Nursing Facility
- Alpena, MI
- NPI 1164948444
B&Y Healthcare S Corp, B&Y Trust, Cody Healthcare S Corp, Craig Flashner 2007 Trust, Prestige Administrative Services, LLC
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.
-
- Family Medicine Physician
- Davison, MI
- NPI 1346342235
-
- Family Medicine Physician
- Brighton, MI
- NPI 1831205806
-
- Internal Medicine Physician
- Royal Oak, MI
- NPI 1811302516
Affiliated clinicians 2
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": "1414368000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1751328000000",
"number": "1790180255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7400 NEW LA GRANGE RD STE 400",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402224870",
"telephone_number": "502-429-8062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11941 BELSAY RD",
"city": "GRAND BLANC",
"state": "MI",
"postal_code": "484391702",
"telephone_number": "810-694-1970",
"fax_number": "810-694-4081"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GRAND BLANC OPCO LLC",
"organizational_subpart": "NO",
"enumeration_date": "2014-10-27",
"last_updated": "2025-07-01",
"certification_date": "2025-07-01",
"status": "A",
"authorized_official_last_name": "ROGERS",
"authorized_official_first_name": "STACEY",
"authorized_official_middle_name": "PAUL",
"authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
"authorized_official_telephone_number": "502-429-0650",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Medilodge of Grand Blanc",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Grand Blanc, MI
- Grand Blanc Footcare Specialists, P.L.L.C.
- Grand Blanc Massage LLC (Hand and Stone)
- Grand Blanc Medical Imaging, PLC
- Grand Blanc Obstetrics & Gynecology PC
- Grand Blanc Opco LLC (Medilodge of Grand Blanc)
- Grand Blanc Pediatric Dentistry PC
- Grand Blanc Pediatrics
- Grand Blanc Periodontal Associates
- Grand Blanc Pharmacy LLC (Grand Blanc Pharmacy)
- Grand Blanc Pharmacy LLC (Grand Blanc Pharmacy)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.