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BOULDER PARK TERRACE
NPI 1508962069
Nursing Facility/Intermediate Care Facility in Charlevoix, MI

Active since September 15, 2006CLIA 23D0708812 · Waiver
3/5
Overall Rating
14676 W UPRIGHT ST, CHARLEVOIX, MI 49720(231) 547-1005 Get Directions Write a Review

NPPES record last updated: August 28, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Boulder Park Terrace NPPES

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

BOULDER PARK TERRACE (NPI 1508962069) is a healthcare organization registered as a nursing facility/intermediate care facility in Charlevoix, Michigan and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists David Bellamy, Cfo, as its authorized official.

NPPES Registry Identity

NPI1508962069
Entity TypeOrganization
Primary Taxonomy313M00000X
Legal Business NameCHARLEVOIX NURSING HOME CORPORATION
Location Address14676 W UPRIGHT STCharlevoix, MI 49720-1201
Mailing Address14676 W Upright StCharlevoix, MI 49720-1201 · (231) 547-1005
Phone(231) 547-1005
Organization SubpartNo
Authorized OfficialDavid BellamyCfo · (231) 487-4094
Enumeration DateSeptember 15, 2006
Last NPPES UpdateAugust 28, 2017
✔ NPI 1508962069 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
Taxonomy Code313M00000X
License✔ Licensed in MI · 235526
Definition
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.
14676 W UPRIGHT ST, Charlevoix, MI 49720
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Other Names 1

Doing Business AsBoulder Park Terrace

Other Identifiers 2

Medicaid2896882MI
Medicare OSCAR/certification235526MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and more.Insurance ›

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 23D0708812

Boulder Park Terrace · Charlevoix, MI
Active · expires Aug 31, 2026
CLIA Number23D0708812
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorTravis S. Johnecheck
Laboratory Phone(231) 237-8009
Laboratory LocationBoulder Park Terrace14676 West Upright Avenue, Charlevoix, MI 49720
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Nursing Home Quality Ratings CMS Care Compare

Quality ratings, staffing and inspection history for Boulder Park Terrace (CMS certification number 235526), from CMS Care Compare.

Boulder Park Terrace

Nursing home · Charlevoix, MI
3/5 CMS Overall Rating
OwnershipNon profit - Corporation
CMS Certification Number235526
Certified Beds72 beds56 residents per day on average
Medicare & Medicaid Participant SinceAugust 14, 1992
Resident & Family CouncilResident council
Automatic sprinkler system

CMS Star Ratings

Quality Measures
Based on a select set of clinical quality measures.
3/5
Long-Stay Quality
Quality of care delivered to long-term residents.
1/5
Short-Stay Quality
Quality of care delivered to short-term and rehabilitation residents.
5/5
Staffing
Based on nursing staff hours relative to resident needs.
3/5
Weighted Health Inspection Score
Lower scores are better; the score summarizes deficiencies found on recent inspections.
86.67
Ratings are assigned by CMS on a one-to-five star scale; five is the highest. Categories without a current CMS rating are not shown.

Staffing & Turnover

Total Nurse Staffing
nurse aide 1.68 · LPN 0.51 · RN 1.24
3.44 hrs per resident per day
Weekend Nurse Staffing
2.82 hrs per resident per day
Physical Therapist Staffing
0.11 hrs per resident per day
Administrators Who Have Left
In the past year.
2
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

Facility-Reported Incidents
8
Substantiated Complaints
3
Fines
0
Medicare Payment Denials
0
Total Penalties
0
Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

Other Providers at the Same Location NPPES 6

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

MRS. MICHONNE MARIE PALMER OT/L
Occupational Therapist
14676 W UPRIGHT ST
CHARLEVOIX, MI 49720
Charlevoix County (231) 267-8012
ADAM JOHN TSALOFF
Physical Therapist
14676 W UPRIGHT ST
CHARLEVOIX, MI 49720
Charlevoix County (231) 237-8012
VERONICA JEAN WETZEL
Occupational Therapy Assistant
14676 W UPRIGHT ST
CHARLEVOIX, MI 49720
Charlevoix County (902) 220-2222
SANDRA LEE MARTIN WHNP-BC
Nurse Practitioner (Women's Health)
14676 W UPRIGHT ST
CHARLEVOIX, MI 49720
Charlevoix County (231) 547-1005
ROBERT STOUT
Physical Therapist
14676 W UPRIGHT ST
CHARLEVOIX, MI 49720
Charlevoix County (231) 237-8012
BROOKE WERNER OTR/L
Occupational Therapist
14676 W UPRIGHT ST
CHARLEVOIX, MI 49720
Charlevoix County (231) 547-1005

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 Charlevoix Nursing Home Corporation's NPI number?

The NPI number for Charlevoix Nursing Home Corporation is 1508962069. It was assigned to this organization in the NPPES registry on September 15, 2006. The provider is doing business as Boulder Park Terrace.

Where is Charlevoix Nursing Home Corporation located?

Charlevoix Nursing Home Corporation is located at 14676 W Upright St, Charlevoix, MI 49720. The listed phone number is (231) 547-1005.

What is Charlevoix Nursing Home Corporation's specialty?

The primary specialty registered for this NPI is Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.

Does Charlevoix Nursing Home Corporation hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D0708812) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Charlevoix Nursing Home Corporation a Medicare-certified nursing home?

Yes. Boulder Park Terrace is a Medicare-certified nursing home with 72 certified beds.

What quality rating does Charlevoix Nursing Home Corporation have?

CMS rates Boulder Park Terrace 3 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

What insurance does Charlevoix Nursing Home Corporation accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and Priority Health list Charlevoix Nursing Home Corporation as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Charlevoix Nursing Home Corporation was last updated on August 28, 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.