Port Huron Opco LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PORT HURON OPCO LLC

Practice address

5635 Lakeshore Rd
Fort Gratiot, MI 48059-2817

Phone

(810) 385-7447

Fax

(810) 385-7114

NPI assigned

Jul 8, 2013

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 PORT HURON Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Skilled nursing facility certification: CCN 235421

Legal name

PORT HURON OPCO LLC

Doing business as

MEDILODGE OF PORT HURON

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF distinct part

Participating since

Feb 12, 1982

Last certification

May 21, 2025

Beds

127

Ownership / control type

Individual

Multi-facility organization

Prestige HCM

Most recent change of ownership

Nov 1, 2013

Organization structure

LLCProprietary

Incorporated

Jun 13, 2013 in DE

Enrollment address

5635 Lakeshore Rd
Fort Gratiot, MI 48059-2817

Nursing home name

MEDILODGE OF PORT HURON

Affiliated entity

MEDILODGE

Listed as

Medilodge of Port HuronCCN 235421

Overall star rating

5 of 5

Health inspections

5 of 5

Staffing

5 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

For profit - Individual

Certified

Feb 12, 1982

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

127118.6 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 12

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

  • 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

  CMS ownership
• Capital Area Opco 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

  CMS ownership
• Cass City Opco 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

  CMS ownership
• Cheboygan Opco 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

  CMS ownership
• Clare Opco 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

  CMS ownership
• East Lansing Opco 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

  CMS ownership
• Farmington Opco LLC

  • Skilled Nursing Facility
  • Farmington, MI
  • NPI 1629442215

  B&Y Healthcare S Corp, B&Y Trust, Cody Healthcare S Corp, Craig Flashner 2007 Trust

  CMS ownership
• Frankenmuth Opco, LLC

  • 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

  CMS ownership
• Gaylord Opco, 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

  CMS ownership
• Grand Blanc Opco 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

  CMS ownership
• Grand Haven Opco 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

  CMS ownership
• Grand Rapids Opco, 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

  CMS ownership

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Emad Daher, MD

  • Internal Medicine Physician
  • Port Huron, MI
  • NPI 1265415285
  NPD (past)
• Daniel C Souphis, D.O.

  • Family Medicine Physician
  • Fort Gratiot, MI
  • NPI 1225004252
  NPD (past)

Affiliated clinicians 3

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

• Emad Daher, MD

  • Internal Medicine Physician
  • Port Huron, MI
  • NPI 1265415285

  Nursing home

  Care Compare affiliation
• Daniel C Souphis, D.O.

  • Family Medicine Physician
  • Fort Gratiot, MI
  • NPI 1225004252

  Nursing home

  Care Compare affiliation
• Reid S Stromberg, M.D.

  • Family Medicine Physician
  • Port Huron, MI
  • NPI 1417062761

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1373241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419897600000",
    "number": "1942641964",
    "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": "5635 LAKESHORE RD",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480592817",
            "telephone_number": "810-385-7447",
            "fax_number": "810-385-7114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORT HURON OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-08",
        "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": "1942641964",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDILODGE OF PORT HURON",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Randy John Plonka, MD
• Holly Plumb
• Elizabeth Anne Poppe
• Port Huron Mercy Family Care Inc
• Port Huron Neurologic Associates P.C.
• Port Huron Physicians Medical Group PC
• Port Huron Physicians Medical Group PC
• Kaylee Rae Porter-Stover
• Skylar Kathleen Potter
• Rebecca Ann Powelson

• Skilled Nursing Facility in Fort Gratiot, MI
• Providers in Fort Gratiot, 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.