NPIMap

Organization Active NPI

McLaren Macomb

  • Psychiatric Hospital Unit
  • Shelby Township, MI
National Provider Identifier
1184206385
Registry record updated Jun 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
Legal business name
MCLAREN MACOMB
Practice address
46810 Schoenherr Rd
Shelby Township, MI 48315
Phone
(586) 493-2059
NPI assigned
Apr 27, 2021
Last updated
Jun 4, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2021

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

Authorized official

Name
Brian S Balutanski
Title
Cfo
Phone
(586) 493-8985

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X NU Primary

Addresses

Primary practice location

46810 Schoenherr Rd
Shelby Township, MI 48315

Mailing address

1 McLaren Pkwy
Grand Blanc, MI 48439-7471
Phone (810) 342-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070406000308 MI Part A Provider - Hospital 8921912791 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clinton Township, MI; Sterling Heights, MI; Shelby Township, MI; Mount Clemens, MI; Lenox, MI; Clinton TWP, MI; Clarkston, MI
O20210812000710 MI Part A Provider - Hospital 8921912791 Practice locations: Shelby Township, MI

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1184206385. Details of each certification follow.

Hospital certification: CCN 230227

Legal name
MCLAREN MACOMB
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Nov 15, 2017
Beds
288
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
1000 Harrington St
Mount Clemens, MI 48043-2920
Main/Primary Hospital Location
Hospital subgroups
Acute care

Hospital certification: CCN 23S227

Legal name
MCLAREN MACOMB
Organization structure
CorporationNon-profit
Enrollment address
46810 Schoenherr Rd
Shelby Township, MI 48315-5304
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric

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

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
McLaren MacombCCN 230227 · All quality measures
Overall star rating
1 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

Locations

46810 Schoenherr Rd
Shelby Township, MI 48315
Phone (586) 493-2059

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Timothy D Logan Individual Corporate DirectorTrustee Feb 5, 2025
Corporate Director Feb 5, 2025
Candice Miller Individual Corporate DirectorTrustee Feb 1, 2017
Robert Cannon Individual Corporate DirectorTrustee Feb 1, 2012
James George Individual Corporate DirectorTrustee Apr 1, 2002
Corporate DirectorTrustee Apr 1, 2012
John Hunt Individual Corporate DirectorTrustee Feb 1, 2011
Tracey Franovich Individual Contracted Managing EmployeePresident/Ceo Jun 13, 2024
Corporate OfficerPresident / Ceo Jun 13, 2024
Corporate DirectorPresident/Ceo Jun 13, 2024
Operational/Managerial ControlPresident / Ceo Jun 13, 2024
Albert a Przybylski Individual Corporate DirectorTrustee Sep 21, 2011
Corporate DirectorTrustee Feb 1, 2014
McLaren Health Care Corporation Organization, Grand Blanc, MI Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2007 100%
Carolyn Dorian Individual Corporate DirectorTrustee Nov 25, 2008
Ted Wahby Individual Corporate DirectorTrustee Feb 5, 2025
Rita Marie Ingersoll Individual Corporate DirectorTrustee May 22, 2018
Steve Snyder Individual Corporate DirectorVP/Cfo Aug 21, 2023
W-2 Managing EmployeeVP/Cfo Aug 21, 2023
Operational/Managerial ControlVP/Cfo Aug 21, 2023

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 58

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

View all 58

Practitioners & affiliated clinicians

Practitioners 1

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.

Affiliated clinicians 455

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 455

NPI Registry JSON

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

{
    "created_epoch": "1619481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622764800000",
    "number": "1184206385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MCLAREN PKWY",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484397471",
            "telephone_number": "810-342-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46810 SCHOENHERR RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "48315",
            "telephone_number": "586-493-2059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLAREN MACOMB",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-27",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A",
        "authorized_official_last_name": "BALUTANSKI",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "586-493-8985"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby Township, MI

Sources for this page

Verify at the official NPI Registry.