Active NPI
Meadow Brook Medical Care Facility
- Skilled Nursing Facility
- Bellaire, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 058510
- Legal business name
- MEADOW BROOK MEDICAL CARE FACILITY
- Practice address
- 4543 S M 88 Hwy
Bellaire, MI 49615-9109 - Phone
- (231) 533-8661
- Fax
- (231) 533-4841
- NPI assigned
- Jun 21, 2005
- Last updated
- Aug 22, 2020
- 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
- Mrs. Judy Martin, RN
- Title
- Administrator
- Phone
- (231) 533-8661
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 058510 | MI | Primary |
Addresses
Primary practice location
4543 S M 88 Hwy
Bellaire, MI 49615-9109
Mailing address
4543 S M 88 Hwy
Bellaire, MI 49615-9109
Phone (231) 533-8661
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09637 | Other | MI | BLUE CROSS BLUE SHIELD |
| 2085141 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111018000358 | MI | Part A Provider - Skilled Nursing Facility | 3375715386 | Practice locations: Bellaire, MI |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1861497398. Details of each certification follow.
Skilled nursing facility certification: CCN 235025
- Legal name
- MEADOW BROOK MEDICAL CARE FACILITY
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF distinct part
- Participating since
- Jan 1, 1967
- Last certification
- Oct 30, 2024
- Beds
- 133
- Ownership / control type
- County
- Organization structure
- Other
- Enrollment address
- 4543 S M 88 Hwy
Bellaire, MI 49615-9109 - Nursing home name
- MEADOW BROOK MEDICAL CARE FACILITY
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Meadow Brook Medical Care Facility
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Government - County
- Certified
- Jan 1, 1967
- Medicare certification status
- Active
- Certified beds
- 133
- Abuse citation
- Cited for abuse (Care Compare abuse icon)
- Penalties (3 years)
- 1
National Provider Directory
National Provider DirectoryMember organizations 1
Organizations listed as members of this organization in the National Provider Directory.
-
dba Meadow Brook Outpatient Therapy
- Rehabilitation Clinic/Center
- Bellaire, MI
- NPI 1790179828
Member Of
Ownership & related parties
All disclosed owners & managing parties 8
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 |
|---|---|---|---|
| Arnold G Muller | Corporate Director | Nov 17, 2022 | |
| Fred Harris | Corporate Director | Nov 1, 2011 | |
| William Hefferan | Corporate Director | Apr 11, 2023 | |
| Maureen Clore | Corporate Director | Apr 24, 2016 | |
| Melissa Zelenak | Corporate Director | Nov 5, 2018 | |
| Marna D Robertson | W-2 Managing Employee | Feb 1, 2006 | 100% |
| Adp of the SNF | Jan 13, 2025 | ||
| Dennis Feihel | Contracted Managing Employee | Apr 29, 2024 | |
| Adp of the SNF | Jan 13, 2025 | ||
| Antrim County | 5% Or Greater Direct Ownership Interest | Jan 1, 1967 | 100% |
| Adp of the SNF | Jan 13, 2025 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Petoskey, MI
- NPI 1437511805
Adp of the SNF, Contracted Managing Employee
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
dba Meadow Brook Outpatient Therapy
- Rehabilitation Clinic/Center
- Bellaire, MI
- NPI 1790179828
Practitioners & affiliated clinicians
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.
-
- Internal Medicine Physician
- Petoskey, MI
- NPI 1437511805
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": "1119312000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1861497398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4543 S M 88 HWY",
"city": "BELLAIRE",
"state": "MI",
"postal_code": "496159109",
"telephone_number": "231-533-8661",
"fax_number": "231-533-4841"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4543 S M 88 HWY",
"city": "BELLAIRE",
"state": "MI",
"postal_code": "496159109",
"telephone_number": "231-533-8661",
"fax_number": "231-533-4841"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEADOW BROOK MEDICAL CARE FACILITY",
"organizational_subpart": "NO",
"enumeration_date": "2005-06-21",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "MARTIN",
"authorized_official_first_name": "JUDY",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "231-533-8661",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "RN"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "MI",
"license": "058510",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "09637",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2085141",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bellaire, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.