Active NPI
Taylor Opco LLC
- Skilled Nursing Facility
- Taylor, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- TAYLOR OPCO LLC
- Practice address
- 23600 Northline Rd
Taylor, MI 48180-4620 - Phone
- (734) 287-8580
- Fax
- (734) 287-2840
- NPI assigned
- Jul 15, 2013
- 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) 429-8062
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
23600 Northline Rd
Taylor, MI 48180-4620
Mailing address
7400 New la Grange Rd
Suite 100
Louisville, KY 40222-4870
Phone (502) 429-8062
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891136115 | Medicaid | MI |
Other names 1
- MEDILODGE OF TAYLOR
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130823000496 | MI | Part A Provider - Skilled Nursing Facility | 8123261153 | Practice locations: Taylor, MI |
Skilled nursing facility certification: CCN 235300
- Legal name
- TAYLOR OPCO LLC
- Doing business as
- MEDILODGE OF TAYLOR
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF distinct part
- Participating since
- Jul 1, 1976
- Last certification
- Oct 17, 2024
- Beds
- 142
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Prestige Healthcare
- Organization structure
- LLC
- Incorporated
- Jun 12, 2013 in DE
- Enrollment address
- 23600 Northline Rd
Taylor, MI 48180-4620 - Nursing home name
- MEDILODGE OF TAYLOR
- Affiliated entity
- MEDILODGE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Medilodge of Taylor
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jul 1, 1976
- Medicare certification status
- Active
- Certified beds
- 142
- Chain
- Medilodge
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D0679794 | Taylor Opco, LLC | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider Directory- Tax ID family
- Medilodge of Taylor
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Skilled Nursing Facility
- Taylor, MI
- NPI 1609836220
Ownership & related parties
All disclosed owners & managing parties 12
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 |
|---|---|---|---|
| Fifteeninone Opco Group LLC | 5% Or Greater Direct Ownership Interest | Jun 24, 2013 | 100% |
| Cody Healthcare S Corp | 5% Or Greater Indirect Ownership Interest | Jun 24, 2013 | 47.55% |
| B&Y Trust | 5% Or Greater Indirect Ownership Interest | Jun 24, 2013 | 47.55% |
| Prestige Administrative Services, LLC | Operational/Managerial Control | Jan 1, 2016 | |
| Craig a Flashner | Corporate Director | Jun 24, 2013 | |
| Operational/Managerial Control | Jun 24, 2013 | ||
| Kristine Ranel Kirk | W-2 Managing Employee | Jan 1, 2016 | |
| Robert L Norcross | Contracted Managing Employee | Jun 24, 2013 | |
| Craig Flashner 2007 Trust | 5% Or Greater Indirect Ownership Interest | Jun 24, 2013 | 47.55% |
| B&Y Healthcare S Corp | 5% Or Greater Indirect Ownership Interest | Jun 24, 2013 | 47.55% |
| Generations Healthcare Management LLC | Operational/Managerial Control | Jun 24, 2013 | |
| Stacey Paul Rogers | Contracted Managing Employee | Oct 20, 2014 | |
| Yitzchok a Perlstein | Corporate Director | Jun 24, 2013 | |
| Operational/Managerial Control | Jun 24, 2013 |
Facilities with the same owner 77
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- 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
-
- 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
-
- 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
-
- 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
-
- 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
-
- 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
-
- Skilled Nursing Facility
- Farmington, MI
- NPI 1629442215
B&Y Healthcare S Corp, B&Y Trust, Cody Healthcare S Corp, Craig Flashner 2007 Trust
-
- 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
-
- 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
-
- Skilled Nursing Facility
- Grand Blanc, MI
- NPI 1790180255
B&Y Healthcare S Corp, B&Y Trust, Cody Healthcare S Corp, Craig Flashner 2007 Trust, Generations Healthcare Management LLC, Prestige Administrative Services, LLC
-
- 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
-
- 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
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Southgate, MI
- NPI 1558561720
-
- Geriatric Medicine (Family Medicine) Physician
- Dearborn, MI
- NPI 1861485500
-
- Internal Medicine Physician
- Garden City, MI
- NPI 1285975250
-
- Internal Medicine Physician
- Taylor, MI
- NPI 1003921891
-
- Internal Medicine Physician
- Wyandotte, MI
- NPI 1558802769
Affiliated clinicians 5
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Geriatric Medicine (Family Medicine) Physician
- Dearborn, MI
- NPI 1861485500
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1373846400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1419897600000",
"number": "1891136115",
"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": "23600 NORTHLINE RD",
"city": "TAYLOR",
"state": "MI",
"postal_code": "481804620",
"telephone_number": "734-287-8580",
"fax_number": "734-287-2840"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TAYLOR OPCO LLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-07-15",
"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": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1891136115",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "MEDILODGE OF TAYLOR",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Taylor, MI
Sources for this page
- 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.