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Organization Active NPI

Baraga County Memorial Hospital

Doing business as Baraga County Home Care & Hospice

  • Home Health Agency
  • L'Anse, MI
National Provider Identifier
1932218807
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
073512 Issued in MI
Legal business name
BARAGA COUNTY MEMORIAL HOSPITAL
Doing business as
Baraga County Home Care & Hospice
Practice address
510 Memorial St
Suite a
Lanse, MI 49946-1138
Phone
(906) 524-4663
NPI assigned
Aug 30, 2006
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
John P Tembreull Jr.
Title
Administrator
Phone
(906) 524-3321

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 073512 MI Primary

Addresses

Primary practice location

510 Memorial St
Suite a
Lanse, MI 49946-1138

Mailing address

510 Memorial St
Suite a
Lanse, MI 49946-1138
Phone (906) 524-4663

Other identifiers 2

IdentifierTypeStateIssuer
3366111MedicaidMI
0E127OtherMIBLUE CROSS

Other names 1

  • Baraga County Home Care & Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030325000010 MI Part A Provider - Home Health Agency 7416866611 Practice locations: Lanse, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1932218807. Details of each certification follow.

Home health agency certification: CCN 237420

Legal name
BARAGA COUNTY MEMORIAL HOSPITAL
Doing business as
BARAGA COUNTY HOME CARE AND HOSPICE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 21, 1997
Last certification
Feb 22, 1997
Ownership / control type
Government Operated
Organization structure
CorporationNon-profit
Enrollment address
18341 US Highway 41
Ste 1
Lanse, MI 49946-8024

Other NPIs with the same Medicare PAC ID 5

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Baraga County Home Care and HospiceCCN 237420 · All quality measures
Overall star rating
2.5 of 5
Ownership
Government Operated
Certified
Mar 21, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Baraga County Mem Hospital8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

18341 US Highway 41
#1
Lanse, MI 49946
Phone (906) 524-3320

510 Memorial St
Ste A
Lanse, MI 49946
Phone (906) 524-4663

615 N Main St
Lanse, MI 49946
Phone (906) 524-6886

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.

NameRoleSinceShare
Shirley Younggren Individual Corporate DirectorBoard Member Mar 7, 2005
Gail Jestila Individual Corporate OfficerCfo Apr 16, 2021
W-2 Managing EmployeeCfo Apr 16, 2021
Cathryn Beer Individual Corporate OfficerBoard Member Sep 10, 2021
James Loman Individual Corporate OfficerBoard Member Sep 10, 2021
Todd V Ingram Individual Corporate DirectorBoard Member Jan 13, 2011
Baraga County Memorial Hospital Organization, Lanse, MI Other Aug 10, 1988
Robert Stowe Individual Corporate OfficerCeo Sep 13, 2021
W-2 Managing EmployeeCeo Sep 13, 2021
Operational/Managerial ControlCeo Sep 13, 2021
Carole L Lapointe Individual Corporate DirectorBoard Member Jan 11, 2011

Owners & managing parties with NPI records 6

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

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Bayside VillageLanse, MI, CCN 235144 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
5% Or Greater Mortgage Interest (57.15%)		 Sep 6, 1995
Jan 18, 2010
Baraga County Home Care & HospiceLanse, MI, CCN 231586 Hospice Operational/Managerial Control Mar 14, 1988

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 78

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.

View all 78

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": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1932218807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 MEMORIAL ST",
            "address_2": "SUITE A",
            "city": "LANSE",
            "state": "MI",
            "postal_code": "499461138",
            "telephone_number": "906-524-4663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 MEMORIAL ST",
            "address_2": "SUITE A",
            "city": "LANSE",
            "state": "MI",
            "postal_code": "499461138",
            "telephone_number": "906-524-4663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARAGA COUNTY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "TEMBREULL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "906-524-3321",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MI",
            "license": "073512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3366111",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0E127",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baraga County Home Care & Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in L'Anse, MI

Sources for this page

Verify at the official NPI Registry.