NPIMap

Organization Active NPI

McLaren Thumb Region

  • Rural Health Clinic/Center
  • Bad Axe, MI
National Provider Identifier
1154942662
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MCLAREN THUMB REGION
Doing business as
McLaren Thumb Region
Practice address
1117 S Van Dyke Rd
Bad Axe, MI 48413-8467
Phone
(989) 269-6170
Fax
(989) 269-2751
NPI assigned
May 6, 2020
Last updated
Nov 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Authorized official

Name
Kenneth Baranski
Title
VP/Cfo
Phone
(989) 269-1510

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

1117 S Van Dyke Rd
Bad Axe, MI 48413-8467

Mailing address

1100 S Van Dyke Rd
Bad Axe, MI 48413-9615
Phone (989) 269-9521

Other names 1

  • McLaren Thumb Region Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210326001381 MI Part A Provider - Rural Health Clinic 6800709221 Practice locations: Bad Axe, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1154942662. Details of each certification follow.

Rural health clinic certification: CCN 238761

Legal name
MCLAREN THUMB REGION
Doing business as
MCLAREN THUMB 1117 BUILDING
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 12, 2021
Last certification
May 12, 2021
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
1117 S Van Dyke Rd
Ste 200, 400
Bad Axe, MI 48413
Related CCNs
231340

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2037570McLaren Thumb Region Scott Mason Primary Care1117 S Van Dyke Suite 200, Bad Axe, MI 48413Certificate of waiverApr 8, 2027

National Provider Directory

National Provider Directory
Tax ID family
Huron Memorial Hosp16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Locations

1117 S Van Dyke Rd
Bad Axe, MI 48413
Phone (989) 269-2597

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Michael Murawski Individual Corporate DirectorTrustee May 1, 2023
Donald J Clark Individual Corporate DirectorDirector Nov 17, 1980
Kenneth E Baranski Individual Corporate OfficerVP/Cfo Mar 27, 2024
W-2 Managing EmployeeVP/Cfo Mar 27, 2024
Operational/Managerial ControlVP/Cfo Mar 27, 2024
John M Hunt Individual Corporate DirectorDirector Nov 26, 2012
Chad Grant Individual Corporate DirectorCoo & MHC Corp Designee Nov 15, 2021
Connie Koutouzos Individual Corporate OfficerPresident/Ceo Nov 15, 2021
Corporate DirectorPresident/Ceo Nov 15, 2021
Operational/Managerial ControlPresident/Ceo Nov 15, 2021
McLaren Health Care Corporation Organization, Grand Blanc, MI Corporation, Non-profit 5% Or Greater Direct Ownership Interest Dec 31, 2020 100%
Mary C Rapson Individual Corporate DirectorDirector Nov 28, 2005

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1588723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731542400000",
    "number": "1154942662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S VAN DYKE RD",
            "city": "BAD AXE",
            "state": "MI",
            "postal_code": "484139615",
            "telephone_number": "989-269-9521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 S VAN DYKE RD",
            "city": "BAD AXE",
            "state": "MI",
            "postal_code": "484138467",
            "telephone_number": "989-269-6170",
            "fax_number": "989-269-2751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLAREN THUMB REGION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-06",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A",
        "authorized_official_last_name": "BARANSKI",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "VP/CFO",
        "authorized_official_telephone_number": "989-269-1510"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McLaren Thumb Region",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "McLaren Thumb Region",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bad Axe, MI

Sources for this page

Verify at the official NPI Registry.