MEDILODGE OF PORT HURON
NPI 1942641964
Skilled Nursing Facility in Fort Gratiot, MI

Active since July 08, 2013CLIA 23D1085791 · Waiver
5/5
Overall Rating
5635 LAKESHORE RD, FORT GRATIOT, MI 48059(810) 385-7447(810) 385-7114 Get Directions Write a Review

NPPES record last updated: December 30, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Medilodge Of Port Huron NPPES

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

MEDILODGE OF PORT HURON (NPI 1942641964) is a healthcare organization registered as a skilled nursing facility in Fort Gratiot, Michigan and active in the NPI registry since July 2013. The organization holds a CLIA Waiver certificate valid through June 25, 2028 and lists Stacey Paul Rogers, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1942641964
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NamePORT HURON OPCO LLC
Location Address5635 LAKESHORE RDFort Gratiot, MI 48059-2817
Mailing Address7400 New La Grange Rd, Suite 100Louisville, KY 40222-4870 · (502) 429-8062 · Fax (502) 429-0650
Fax(810) 385-7114
Organization SubpartNo
Authorized OfficialStacey Paul RogersChief Financial Officer · (502) 429-8062
Enumeration DateJuly 8, 2013
Last NPPES UpdateDecember 30, 2014
NPI 1942641964 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.
5635 LAKESHORE RD, Fort Gratiot, MI 48059

Other Names 1

Doing Business AsMedilodge Of Port Huron

Other Identifiers 2

Medicare OSCAR/certification235421
Medicaid1942641964MI

Accepted 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 23D1085791

Port Huron Opco, LLC · Fort Gratiot, MI
Active · expires Jun 25, 2028
CLIA Number23D1085791
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateJune 26, 2026
Certificate Expiration DateJune 25, 2028
Laboratory DirectorJoanna Gorecki
Laboratory Phone(810) 385-7447
Laboratory LocationPort Huron Opco, LLC5635 Lakeshore Road, Fort Gratiot, MI 48059
CLIA data matches this NPI record on: Address Name Phone
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 Medilodge Of Port Huron (CMS certification number 235421), from CMS Care Compare.

Medilodge Of Port Huron

Nursing home · Fort Gratiot, MI
5/5 CMS Overall Rating
OwnershipFor profit - Limited Liability company
CMS Certification Number235421
Certified Beds127 beds114 residents per day on average
Medicare & Medicaid Participant SinceFebruary 12, 1982
Resident & Family CouncilResident council
Automatic sprinkler system

CMS Star Ratings

Quality Measures
Based on a select set of clinical quality measures.
4/5
Long-Stay Quality
Quality of care delivered to long-term residents.
4/5
Short-Stay Quality
Quality of care delivered to short-term and rehabilitation residents.
4/5
Staffing
Based on nursing staff hours relative to resident needs.
4/5
Weighted Health Inspection Score
Lower scores are better; the score summarizes deficiencies found on recent inspections.
27.33
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 2.31 · LPN 0.86 · RN 0.68
3.85 hrs per resident per day
Weekend Nurse Staffing
3.12 hrs per resident per day
Physical Therapist Staffing
0.05 hrs per resident per day
Nursing Staff Turnover
Share of nursing staff who left the facility within the past year.
45.4%
Registered Nurse Turnover
47.6%
Administrators Who Have Left
In the past year.
1
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

Facility-Reported Incidents
1
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 7

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

Speech-Language Pathologist
5635 LAKESHORE RD
FORT GRATIOT, MI 48059
Physical Therapy Assistant
5635 LAKESHORE RD
FORT GRATIOT, MI 48059
Occupational Therapy Assistant
5635 LAKESHORE RD
FORT GRATIOT, MI 48059
Physical Therapist
5635 LAKESHORE RD
FORT GRATIOT, MI 48059
Skilled Nursing Facility
5635 LAKESHORE RD
FORT GRATIOT, MI 48059
Occupational Therapy Assistant
5635 LAKESHORE RD
FORT GRATIOT, MI 48059
Skilled Nursing Facility
5635 LAKESHORE RD
FORT GRATIOT, MI 48059

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 Port Huron Opco LLC's NPI number?

The NPI number for Port Huron Opco LLC is 1942641964. It was assigned to this organization in the NPPES registry on July 8, 2013. The provider is doing business as Medilodge Of Port Huron.

Where is Port Huron Opco LLC located?

Port Huron Opco LLC is located at 5635 Lakeshore Rd, Fort Gratiot, MI 48059. The listed phone number is (810) 385-7447.

What is Port Huron Opco LLC's specialty?

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

Does Port Huron Opco LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D1085791) is associated with this NPI, valid through June 25, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Port Huron Opco LLC a Medicare-certified nursing home?

Yes. Medilodge Of Port Huron is a Medicare-certified nursing home with 127 certified beds.

What quality rating does Port Huron Opco LLC have?

CMS rates Medilodge Of Port Huron 5 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

What insurance does Port Huron Opco LLC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 3 other insurers list Port Huron Opco LLC 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 Port Huron Opco LLC was last updated on December 30, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.