Active NPI
Portage Hospital LLC
Doing business as Portage Health
- Medicare Defined Swing Bed Hospital Unit
- Hancock, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medicare Defined Swing Bed Hospital Unit
- Legal business name
- PORTAGE HOSPITAL LLC
- Doing business as
- Portage Health
- Practice address
- 500 Campus Dr
Hancock, MI 49930-1569 - Phone
- (906) 483-1000
- NPI assigned
- Oct 11, 2013
- Last updated
- May 1, 2024
- Organization subpart
- Yes
- Parent organization
- PORTAGE HOSPITAL LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Charlotte Lawrence
- Title
- Secretary
- Phone
- (615) 920-7000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medicare Defined Swing Bed Hospital Unit | 275N00000X | Primary |
Addresses
Primary practice location
500 Campus Dr
Hancock, MI 49930-1569
Mailing address
330 Seven Springs Way
Brentwood, TN 37027-4536
Phone (615) 920-7000
Other names 1
- Portage Health
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | phs@direct.uphsportage.net |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140123001486 | MI | Part A Provider - Hospital | 1951538883 | Practice locations: Hancock, MI |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1821425612. Details of each certification follow.
Hospital certification: CCN 23U108
- Legal name
- PORTAGE HOSPITAL LLC
- Doing business as
- UP HEALTH SYSTEM PORTAGE
- Organization structure
- LLC
- Incorporated
- Apr 17, 2013 in MI
- Enrollment address
- 500 Campus Dr
Hancock, MI 49930-1452 - Hospital subgroups
- Swing-bed approved
Related certifications (CCN) 1
Facilities connected through Provider of Services related, parent or unit certification numbers.
-
dba UP Health System Portage
- General Acute Care Hospital
- Hancock, MI
- NPI 1245667229
Unit of hospital
Other NPIs with the same Medicare PAC ID 4
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba PortagePointe
- Skilled Nursing Facility
- Hancock, MI
- NPI 1104253921
1951538883
-
dba UP Health System Portage
- General Acute Care Hospital
- Hancock, MI
- NPI 1245667229
1951538883
-
dba Portage Health Dialysis Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Hancock, MI
- NPI 1366879199
1951538883
-
dba UP Health System Portage
- Durable Medical Equipment & Medical Supplies
- Hancock, MI
- NPI 1710314547
1951538883
National Provider Directory
National Provider Directory- Tax ID family
- Portage Hospital LLC
- Part of
- Portage Hospital LLC
Other organizations with this tax ID 7
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Portage Health Home Care and Hospice
- Home Health Agency
- Hancock, MI
- NPI 1649316142
-
- Audiologist
- Hancock, MI
- NPI 1073943783
-
dba UP Health System Home Care and Hospice Portage
- Emergency Response System Companies
- Hancock, MI
- NPI 1134574940
-
dba Portage Health Hearing Services
- Hearing Aid Equipment
- Hancock, MI
- NPI 1174950901
-
dba Portage Health Dialysis Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Hancock, MI
- NPI 1366879199
-
dba UP Health System Portage
- Durable Medical Equipment & Medical Supplies
- Hancock, MI
- NPI 1710314547
Ownership & related parties
All disclosed owners & managing parties 22
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 |
|---|---|---|---|
| Lifepoint Holdings 2 LLC | 5% Or Greater Indirect Ownership Interest | Apr 17, 2013 | 80% |
| Ryan K. Heinonen | W-2 Managing Employee | Jan 10, 2022 | |
| Portage Health Foundation | 5% Or Greater Indirect Ownership Interest | Dec 1, 2013 | 20% |
| Portage Holding Company LLC | 5% Or Greater Direct Ownership Interest | Apr 17, 2013 | 100% |
| Bruce a. Rukkila | Other | Aug 5, 2019 | |
| Kevin Store | Other | Nov 1, 2016 | |
| William W Liston | Other | Nov 30, 2013 | |
| DSB Acquisition LLC | 5% Or Greater Indirect Ownership Interest | Nov 16, 2018 | 80% |
| Lifepoint Hospitals Holdings LLC | 5% Or Greater Indirect Ownership Interest | Apr 17, 2013 | 80% |
| Elmer B Polite | Corporate Officer | Dec 14, 2020 | |
| Other | Dec 14, 2020 | ||
| Historic Lifepoint Hospitals, LLC | 5% Or Greater Indirect Ownership Interest | Apr 17, 2013 | 80% |
| Timothy John Labonte | Other | May 7, 2020 | |
| Lifepoint Health Inc | 5% Or Greater Indirect Ownership Interest | Nov 16, 2018 | 80% |
| Marcus B Poppell | Corporate Officer | Nov 16, 2018 | |
| Other | Dec 1, 2013 | ||
| Kristine Weidner | Other | Jun 1, 2017 | |
| Charlotte E Lawrence | Corporate Officer | Feb 10, 2022 | |
| HSC Manager LLC | Operational/Managerial Control | Dec 1, 2013 | |
| Loren Rials | Corporate Officer | Nov 9, 2023 | |
| Teresa Williams | Other | May 31, 2024 | |
| John Michael Grooms | Corporate Officer | Nov 1, 2016 | |
| Christopher J Monte | Corporate Officer | Apr 17, 2013 | |
| Legacy Lifepoint Health LLC | 5% Or Greater Indirect Ownership Interest | Apr 17, 2013 | 80% |
Owners & managing parties with NPI records 2
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
Facilities with the same owner 193
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba UP Health System Bell
- Critical Access Hospital
- Ishpeming, MI
- NPI 1699101345
Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC
-
dba UP Health System Bell
- Medicare Defined Swing Bed Hospital Unit
- Ishpeming, MI
- NPI 1760819858
Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC
-
dba UP Medical Group - Bell Women's Care
- Rural Health Clinic/Center
- Ishpeming, MI
- NPI 1114726676
Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC
-
dba UP Health System Marquette
- Rehabilitation Hospital Unit
- Marquette, MI
- NPI 1134474737
Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC
-
dba UP Health System Marquette
- General Acute Care Hospital
- Marquette, MI
- NPI 1568727048
Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC
-
dba UP Health System Marquette
- Psychiatric Hospital Unit
- Marquette, MI
- NPI 1699020289
Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC
-
dba UP Health System Pediatric Specialists
- Rural Health Clinic/Center
- Marquette, MI
- NPI 1205635760
Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC
-
dba UP Health System Family Medicine
- Rural Health Clinic/Center
- Escanaba, MI
- NPI 1679372130
Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC
-
dba UP Health System Home Care and Hospice
- Home Health Agency
- Marquette, MI
- NPI 1457899668
Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Hospitals Holdings LLC
-
dba UP Health System Home Care and Hospice Portage
- Home Health Agency
- Houghton, MI
- NPI 1942749726
Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Hospitals Holdings LLC
-
dba PortagePointe
- Skilled Nursing Facility
- Hancock, MI
- NPI 1104253921
Historic Lifepoint Hospitals, LLC, HSC Manager LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC, Portage Health Foundation, Portage Holding Company LLC
-
dba UP Health System Portage
- General Acute Care Hospital
- Hancock, MI
- NPI 1245667229
Historic Lifepoint Hospitals, LLC, HSC Manager LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC, Portage Health Foundation, Portage Holding Company LLC
Practitioners & affiliated clinicians
Practitioners 32
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.
-
- Emergency Medicine Physician
- Detroit, MI
- NPI 1760611198
-
- Nurse Practitioner
- Hancock, MI
- NPI 1386049211
-
- Emergency Medicine Physician
- Muskegon, MI
- NPI 1235510843
-
- Physician Assistant
- Hancock, MI
- NPI 1861734873
-
- Family Nurse Practitioner
- Hancock, MI
- NPI 1154019750
-
- Obstetrics & Gynecology Physician
- Hancock, MI
- NPI 1821679978
-
- Orthopaedic Surgery Physician
- Jackson, MI
- NPI 1578555751
-
- Emergency Medicine Physician
- Grand Rapids, MI
- NPI 1104230341
-
- Nurse Practitioner
- Hancock, MI
- NPI 1306506050
-
- Pediatric Orthopaedic Surgery Physician
- Traverse City, MI
- NPI 1053538868
-
- Internal Medicine Physician
- Midland, MI
- NPI 1538160296
-
- Internal Medicine Physician
- Warren, MI
- NPI 1679580104
Affiliated clinicians 4
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": "1381449600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1714521600000",
"number": "1821425612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 SEVEN SPRINGS WAY",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370274536",
"telephone_number": "615-920-7000",
"fax_number": "615-920-8913"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 CAMPUS DR",
"city": "HANCOCK",
"state": "MI",
"postal_code": "499301569",
"telephone_number": "906-483-1000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PORTAGE HOSPITAL LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PORTAGE HOSPITAL LLC",
"enumeration_date": "2013-10-11",
"last_updated": "2024-05-01",
"certification_date": "2024-05-01",
"status": "A",
"authorized_official_last_name": "LAWRENCE",
"authorized_official_first_name": "CHARLOTTE",
"authorized_official_title_or_position": "SECRETARY",
"authorized_official_telephone_number": "615-920-7000"
},
"taxonomies": [
{
"code": "275N00000X",
"taxonomy_group": "",
"desc": "Medicare Defined Swing Bed Unit",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "phs@direct.uphsportage.net",
"affiliation": "N",
"address_1": "500 Campus Dr",
"city": "Hancock",
"state": "MI",
"country_code": "US",
"postal_code": "499301569",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Portage Health",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Portage Health",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Hancock, MI
- Portage Hospital LLC (UP Health System Portage)
- Portage Hospital LLC (Portage Health Home Care and Hospice)
- Portage Hospital LLC (Portage Health Dialysis Center)
- Portage Hospital LLC (Portage Health Home Care and Hospice)
- Portage Hospital LLC (UP Health System Portage)
- Portage Physician Practices Inc
- Portage Physician Practices Inc
- Verdon Jill Posey
- Jesse R Primeau, PA-C
- Amy Sue Anne Rajala
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.