MEDILODGE OF GAYLORD
NPI 1154848224
Skilled Nursing Facility in Gaylord, MI

Active since August 29, 2017CLIA 23D0669189 · Waiver
508 RANDOM LN, GAYLORD, MI 49735(989) 732-3508 Get Directions Write a Review

NPPES record last updated: August 29, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Medilodge Of Gaylord NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MEDILODGE OF GAYLORD (NPI 1154848224) is a healthcare organization registered as a skilled nursing facility in Gaylord, Michigan and active in the NPI registry since August 2017. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Stacey Paul Rogers, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1154848224
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameGAYLORD OPCO, LLC
Location Address508 RANDOM LNGaylord, MI 49735-9304
Mailing Address7400 New La Grange Rd Ste 100Louisville, KY 40222-4870 · (502) 429-8062
Organization SubpartNo
Authorized OfficialStacey Paul RogersChief Financial Officer · (502) 429-8062
Enumeration DateAugust 29, 2017
NPI 1154848224 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
508 RANDOM LN, Gaylord, MI 49735

Other Names 1

Doing Business AsMedilodge Of Gaylord

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D0669189

Gaylord Opco, LLC · Gaylord, MI
Active · expires Aug 31, 2026
CLIA Number23D0669189
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorRebecca Brehmer
Laboratory Phone(989) 732-3508
Laboratory LocationGaylord Opco, LLC508 Randon Lane, Gaylord, MI 49735
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Occupational Therapy Assistant
508 RANDOM LN
GAYLORD, MI 49735
Skilled Nursing Facility
508 RANDOM LN, RTE. 1
GAYLORD, MI 49735
Physical Therapy Assistant
508 RANDOM LN
GAYLORD, MI 49735
Occupational Therapy Assistant
508 RANDOM LN
GAYLORD, MI 49735
Contractor
508 RANDOM LN
GAYLORD, MI 49735
Occupational Therapist
508 RANDOM LN
GAYLORD, MI 49735
Internal Medicine
508 RANDOM LN
GAYLORD, MI 49735
Skilled Nursing Facility
508 RANDOM LN
GAYLORD, MI 49735

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gaylord Opco, LLC's NPI number?

The NPI number for Gaylord Opco, LLC is 1154848224. It was assigned to this organization in the NPPES registry on August 29, 2017. The provider is doing business as Medilodge Of Gaylord.

Where is Gaylord Opco, LLC located?

Gaylord Opco, LLC is located at 508 Random Ln, Gaylord, MI 49735. The listed phone number is (989) 732-3508.

What is Gaylord Opco, LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Gaylord Opco, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D0669189) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Gaylord Opco, LLC was last updated on August 29, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.