Active NPI
Grand Traverse Pavilions Home Healthcare
- Home Health Agency
- Traverse City, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- 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 PAVILIONS
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Government
- 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 Pavilions
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Government - County
- Certified
- Jan 11, 1967
- Medicare certification status
- Active
- Certified beds
- 240
- Abuse citation
- Cited for abuse (Care Compare abuse icon)
- Penalties (3 years)
- 5
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Adp of the SNF | Oct 1, 2018 | ||
| Carol Crawford | Managing Control - Governing Body | Jan 1, 2024 | |
| Adp of the SNF | Jan 1, 2024 | ||
| David Hautamaki | Operational/Managerial Control | Dec 21, 2024 | |
| Adp of the SNF | Dec 21, 2024 | ||
| Karen Griggs | Managing Control - Governing Body | Dec 20, 2024 | |
| Adp of the SNF | Dec 20, 2024 | ||
| Darrell Lavender | Operational/Managerial Control | Jul 21, 2025 | |
| Adp of the SNF | Jul 21, 2025 | ||
| Mary Marois | Managing Control - Governing Body | Jan 1, 2024 | |
| Adp of the SNF | Jan 1, 2024 | ||
| County of Grand Traverse | 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.
-
- Public Health or Welfare Agency
- Traverse City, MI
- NPI 1174670459
5% Or Greater Direct Ownership Interest, Adp of the SNF
-
- Skilled Nursing Facility
- Traverse City, MI
- NPI 1326124322
5% Or Greater Direct Ownership Interest, Adp of the SNF
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.
-
- Rehabilitation Clinic/Center
- Traverse City, MI
- NPI 1649304270
Practitioners & affiliated clinicians
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Family Medicine Physician
- Traverse City, MI
- NPI 1891994026
Nursing home
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
- Grand Traverse Ophthalmology Clinic PC
- Grand Traverse Oral Surgery, P.C.
- Grand Traverse Orthopedics PLLC
- Grand Traverse Pathology, PLLC
- Grand Traverse Pavilions
- Grand Traverse Physical Therapy, P.C.
- Grand Traverse Physician Services PC
- Grand Traverse Primary Care PLC
- Grand Traverse Radiologists PC
- Grand Traverse Resource Center
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2011; 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.