Medilodge of Yale Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

MEDILODGE OF YALE INC

Doing business as

Medilodge of Yale

Practice address

90 Jean St
Yale, MI 48097-2932

Phone

(810) 387-3226

Fax

(810) 387-3050

NPI assigned

Mar 27, 2006

Last updated

Dec 30, 2014By 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

Mr. Stacey Paul Rogers

Title

Chief Financial Officer

Phone

(502) 429-8062

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MEDILODGE OF YALE Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1871553495. Details of each certification follow.

• CCN 235371 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 235371

Legal name

MEDILODGE OF YALE, INC.

Doing business as

MEDILODGE OF YALE

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Mar 1, 1978

Last certification

May 23, 2024

Beds

108

Ownership / control type

Corporation

Organization structure

CorporationProprietary

Incorporated

Mar 23, 1982 in MI

Enrollment address

90 Jean St
Yale, MI 48097-2932

Nursing home name

MEDILODGE OF YALE

Affiliated entity

MEDILODGE

Listed as

Medilodge of YaleCCN 235371 · All quality measures

Overall star rating

5 of 5

Health inspections

5 of 5

Staffing

4 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Mar 1, 1978

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

10888.9 residents per day on average

Chain

Medilodge53 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 10

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

Facilities with the same owner 77

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

• Alpena Opco LLC

  dba Medilodge of Alpena

  • Skilled Nursing Facility
  • Alpena, MI
  • NPI 1891211264

  B&Y Trust, Craig Flashner 2007 Trust, Prestige Administrative Services, LLC

  CMS ownership
• Capital Area Opco LLC

  dba Medilodge of Capital Area

  • Skilled Nursing Facility
  • Lansing, MI
  • NPI 1528465739

  B&Y Trust, Craig Flashner 2007 Trust, Prestige Administrative Services, LLC

  CMS ownership
• Cass City Opco LLC

  dba Medilodge of Cass City

  • Skilled Nursing Facility
  • Cass City, MI
  • NPI 1316344526

  B&Y Trust, Craig Flashner 2007 Trust, Prestige Administrative Services, LLC

  CMS ownership
• Cheboygan Opco LLC

  dba Medilodge of Cheboygan

  • Skilled Nursing Facility
  • Cheboygan, MI
  • NPI 1295251676

  B&Y Trust, Craig Flashner 2007 Trust, Prestige Administrative Services, LLC

  CMS ownership
• Clare Opco LLC

  dba Medilodge of Clare

  • Skilled Nursing Facility
  • Clare, MI
  • NPI 1659778868

  B&Y Trust, Craig Flashner 2007 Trust, Prestige Administrative Services, LLC

  CMS ownership
• East Lansing Opco LLC

  dba Medilodge of Campus Area

  • Skilled Nursing Facility
  • East Lansing, MI
  • NPI 1730546250

  B&Y Trust, Craig Flashner 2007 Trust, Prestige Administrative Services, LLC

  CMS ownership
• Farmington Opco LLC

  dba Medilodge of Farmington

  • Skilled Nursing Facility
  • Farmington, MI
  • NPI 1629442215

  B&Y Trust, Craig Flashner 2007 Trust

  CMS ownership
• Frankenmuth Opco, LLC

  dba Medilodge of Frankenmuth

  • Skilled Nursing Facility
  • Frankenmuth, MI
  • NPI 1427455641

  B&Y Trust, Craig Flashner 2007 Trust, Prestige Administrative Services, LLC

  CMS ownership
• Gaylord Opco, LLC

  dba Medilodge of Gaylord

  • Skilled Nursing Facility
  • Gaylord, MI
  • NPI 1215453691

  B&Y Trust, Craig Flashner 2007 Trust, Prestige Administrative Services, LLC

  CMS ownership
• Grand Blanc Opco LLC

  dba Medilodge of Grand Blanc

  • Skilled Nursing Facility
  • Grand Blanc, MI
  • NPI 1790180255

  B&Y Trust, Craig Flashner 2007 Trust, Generations Healthcare Management LLC, Prestige Administrative Services, LLC

  CMS ownership
• Grand Haven Opco LLC

  dba Medilodge at the Shore

  • Skilled Nursing Facility
  • Grand Haven, MI
  • NPI 1770078263

  B&Y Trust, Craig Flashner 2007 Trust, Prestige Administrative Services, LLC

  CMS ownership
• Grand Rapids Opco, LLC

  dba Medilodge of Grand Rapids

  • Skilled Nursing Facility
  • Grand Rapids, MI
  • NPI 1083347660

  B&Y Trust, Craig Flashner 2007 Trust, Prestige Administrative Services, LLC

  CMS ownership

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.

• Christina Louise Blevins, D.O.

  • Internal Medicine Physician
  • Livonia, MI
  • NPI 1104146471
  NPD (past)
• Alexander James Cusmano, MD

  • Internal Medicine Physician
  • Troy, MI
  • NPI 1164757514
  NPD (past)
• Samuel E Ross, M.D.

  • Family Medicine Physician
  • Wakeman, OH
  • NPI 1275979296
  NPD (past)

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Samuel E Ross, M.D.

  • Family Medicine Physician
  • Wakeman, OH
  • NPI 1275979296

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419897600000",
    "number": "1871553495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 NEW LA GRANGE RD",
            "address_2": "SUITE 100",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224870",
            "telephone_number": "502-429-8062",
            "fax_number": "502-429-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 JEAN ST",
            "city": "YALE",
            "state": "MI",
            "postal_code": "480972932",
            "telephone_number": "810-387-3226",
            "fax_number": "810-387-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDILODGE OF YALE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-27",
        "last_updated": "2014-12-30",
        "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": "502-429-8062",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1871553495",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDILODGE OF YALE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Matthew Richard Luttrell, P.A.-C
• Main Street Dentistry, PC
• Jennifer Marchetti
• Mary L. Vinckier, D.D.S., P.C.
• Marissa McCann
• Alison Pemberton, PT
• Ryan Schroeder DDS PC
• SDS Pharmacy (Sheldon Pharmacy)
• SDS Pharmacy Inc (Sheldon Pharmacy of Yale, Inc.)
• Shelley Sue Seigel

• Skilled Nursing Facility in Yale, MI
• Providers in Yale, 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 Dec 30, 2014; 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.

Verify at the official NPI Registry.