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Organization Active NPI

Munson Healthcare Otsego Memorial Hospital

Doing business as Munson Healthcare McReynold's Hall

  • Skilled Nursing Facility
  • Gaylord, MI
National Provider Identifier
1851341333
Registry record updated Apr 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
693010 Issued in MI
Legal business name
MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL
Doing business as
Munson Healthcare McReynold's Hall
Munson Healthcare McReynolds Hall
Otsego Memorial Hospital LTCU
Practice address
825 N Center Ave
Gaylord, MI 49735
Phone
(989) 731-2100
Fax
(989) 731-2205
NPI assigned
May 12, 2006
Last updated
Apr 23, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2026

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

Authorized official

Name
Kirsten Bethany Korth-White
Title
Pres/Ceo East Region
Phone
(989) 348-0720

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 693010 MI Primary

Addresses

Primary practice location

825 N Center Ave
Gaylord, MI 49735

Mailing address

825 N Center Ave
Gaylord, MI 49735-1592
Phone (989) 731-2100

Other identifiers 3

IdentifierTypeStateIssuer
15027OtherMIPRIMARY BC ID
09539OtherMISECOND BC ID
62 2000538MedicaidMI

Other names 3

  • Munson Healthcare McReynold's Hall Doing business as
  • Munson Healthcare McReynolds Hall Doing business as
  • Otsego Memorial Hospital LTCU Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091005000621 MI Part A Provider - Skilled Nursing Facility 8325942535 Practice locations: Gaylord, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1851341333. Details of each certification follow.

Skilled nursing facility certification: CCN 235006

Legal name
MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL
Doing business as
MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL LTCU
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Jan 1, 1967
Last certification
Feb 13, 2025
Beds
34
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Munson Healthcare
Organization structure
CorporationNon-profit
Enrollment address
825 N Center Ave
Gaylord, MI 49735-1592
Nursing home name
MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL LTCU

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Munson Healthcare Otsego Memorial Hospital LTCUCCN 235006 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
5 of 5
Quality measures
3 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
3427.2 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Munson Healthcare Otsego Memorial Hospital32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

Organizations that report the same tax identification number in the National Provider Directory.

View all 31

Ownership & related parties

All disclosed owners & managing parties 25

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Andrew Page Individual Managing Control - Governing BodyBoard Member Jan 1, 2024
Adp of the SNF Jan 1, 2024
Benjamin Elliot Individual Operational/Managerial Control Apr 1, 2025
Adp of the SNF Apr 1, 2025
Ruth Hoppe Individual Managing Control - Governing BodyBoard Member Jan 1, 2022
Adp of the SNF Jan 1, 2022
Paul Konopacki Individual Corporate DirectorCfo Apr 15, 2025 100%
Adp of the SNF Apr 15, 2025
Vincent Schultz Individual Managing Control - Governing BodyBoard Member Jan 1, 2024
Adp of the SNF Jan 1, 2024
Thomas Veryser Individual Managing Control - Governing BodyBoard Member Jan 1, 2022
Adp of the SNF Jan 1, 2022
Kenneth D Bloem Individual Managing Control - Governing BodyBoard Member Jan 1, 2022
Adp of the SNF Jan 1, 2022
Timothy Nelson Individual Managing Control - Governing BodyBoard Member Jan 1, 2022
Adp of the SNF Jan 1, 2022
David Menegebier Individual Managing Control - Governing BodyBoard Member Jan 1, 2024
Adp of the SNF Jan 1, 2024
Edward Lanphier Individual Managing Control - Governing BodyBoard Member Jan 1, 2026
Adp of the SNF Jan 1, 2026
Kathy Dixon Individual Managing Control - Governing BodyBoard Member Jan 1, 2022
Adp of the SNF Jan 1, 2022
Kirsten Bethany Korth-White Individual Operational/Managerial Control Jan 1, 2025
Trustee of the SNF Jan 30, 2023
Adp of the SNF Jan 30, 2023
Steven J Wisniewski Individual Operational/Managerial Control Jan 1, 2024
Adp of the SNF Jan 1, 2024
Mary Sanders Individual Managing Control - Governing BodyBoard Member Jan 1, 2022
Adp of the SNF Jan 1, 2022
Elaine Wood Individual Managing Control - Governing BodyBoard Member Jan 1, 2022
Adp of the SNF Jan 1, 2022
Claudia Rowland Individual Managing Control - Governing BodyBoard Member Jan 1, 2026
Adp of the SNF Jan 1, 2026
Munson Healthcare Organization, Traverse City, MI 5% Or Greater Direct Ownership Interest Oct 2, 2019 100%
Trustee of the SNF Oct 2, 2019
Adp of the SNF May 15, 2025
Edwin a Ness Individual Managing Control - Governing BodyBoard Member Jul 1, 2004
Adp of the SNF Jul 1, 2004
Owen Roberts Individual Managing Control - Governing BodyBoard Member Jan 1, 2022
Adp of the SNF Jan 1, 2022
Bruce Zenner Individual Managing Control - Governing BodyBoard Member Jan 1, 2022
Adp of the SNF Jan 1, 2022
Sakura Takano Individual Managing Control - Governing BodyBoard Member Jan 1, 2022
Adp of the SNF Jan 1, 2022
Kristine Thomas Individual Managing Control - Governing BodyBoard Member Jan 1, 2022
Adp of the SNF Jan 1, 2022
Brian Postma Individual Managing Control - Governing BodyBoard Member Jan 1, 2022
Adp of the SNF Jan 1, 2022
Dino Recchia Individual Managing Control - Governing BodyBoard Member Jan 1, 2024
Adp of the SNF Jan 1, 2024
Jennifer King Individual Managing Control - Governing BodyBoard Member Jan 1, 2024
Adp of the SNF Jan 1, 2024

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 24

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 24

Practitioners & affiliated clinicians

Practitioners 2

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 1

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": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776902400000",
    "number": "1851341333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 N CENTER AVE",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497351592",
            "telephone_number": "989-731-2100",
            "fax_number": "989-731-2205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 N CENTER AVE",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "49735",
            "telephone_number": "989-731-2100",
            "fax_number": "989-731-2205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A",
        "authorized_official_last_name": "KORTH-WHITE",
        "authorized_official_first_name": "KIRSTEN",
        "authorized_official_middle_name": "BETHANY",
        "authorized_official_title_or_position": "PRES/CEO EAST REGION",
        "authorized_official_telephone_number": "989-348-0720"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MI",
            "license": "693010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIMARY BC ID",
            "identifier": "15027",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SECOND BC ID",
            "identifier": "09539",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "62 2000538",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Munson Healthcare McReynold's Hall",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Munson Healthcare McReynolds Hall",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Otsego Memorial Hospital LTCU",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Otsego Memorial Hospital LTCU",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gaylord, MI

Sources for this page

Verify at the official NPI Registry.