Organization Active NPI

Grand Traverse Pavilions Home Healthcare

  • Home Health Agency
  • Traverse City, MI
National Provider Identifier
1972802908
Registry record updated Mar 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
GRAND TRAVERSE PAVILIONS HOME HEALTHCARE
Practice address
1000 Pavillions Cir
Traverse City, MI 49684-3198
Phone
(231) 932-3000
NPI assigned
Mar 16, 2011
Organization subpart
Yes
Parent organization
GRAND TRAVERSE PAVILIONSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 16, 2011

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

Authorized official

Name
Mr. Korvyn R Hansen
Title
Administrator/Ceo
Phone
(231) 932-3021

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

1000 Pavillions Cir
Traverse City, MI 49684-3198

Mailing address

1000 Pavillions Cir
Traverse City, MI 49684-3198
Phone (231) 932-3000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110816000736 MI Part A Provider - Skilled Nursing Facility 7911176581 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Traverse City, MI

Skilled nursing facility certification: CCN 235088

Legal name
COUNTY OF GRAND TRAVERSE
Doing business as
GRAND TRAVERSE MEDICAL CARE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 11, 1967
Last certification
Sep 19, 2024
Beds
240
Ownership / control type
County
Organization structure
GovernmentNon-profit
Enrollment address
1000 Pavillions Cir
Traverse City, MI 49684-3198
Nursing home name
GRAND TRAVERSE PAVILIONS

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Nursing home

Medicare Care Compare
Listed as
Grand Traverse PavilionsCCN 235088
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
1 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Government - County
Certified
Jan 11, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
240188.2 residents per day on average
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
5Fines totaling $157,954

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Part of
K-Town Youth Care

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Individual Adp of the SNF Oct 1, 2018
Carol Crawford Individual Managing Control - Governing BodyDHHS Board Vice Chairperson Jan 1, 2024
Adp of the SNF Jan 1, 2024
David Hautamaki Individual Operational/Managerial Control Dec 21, 2024
Adp of the SNF Dec 21, 2024
Karen Griggs Individual Managing Control - Governing BodyDHHS Board Member Dec 20, 2024
Adp of the SNF Dec 20, 2024
Darrell Lavender Individual Operational/Managerial Control Jul 21, 2025
Adp of the SNF Jul 21, 2025
Mary Marois Individual Managing Control - Governing BodyDHHS Board Chairperson Jan 1, 2024
Adp of the SNF Jan 1, 2024
County of Grand Traverse Organization, Traverse City, MI 5% Or Greater Direct Ownership Interest Jan 1, 1966 100%
Adp of the SNF Jun 4, 1998

Owners & managing parties with NPI records 2

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

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

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": "1300233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300233600000",
    "number": "1972802908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 PAVILLIONS CIR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496843198",
            "telephone_number": "231-932-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 PAVILLIONS CIR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496843198",
            "telephone_number": "231-932-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND TRAVERSE PAVILIONS HOME HEALTHCARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GRAND TRAVERSE PAVILIONS",
        "enumeration_date": "2011-03-16",
        "last_updated": "2011-03-16",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "KORVYN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "ADMINISTRATOR/CEO",
        "authorized_official_telephone_number": "231-932-3021",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.