Individual provider Active NPI

Kenneth M Mackinnon, M.D.

  • Family Medicine Physician
  • Freeland, MI
National Provider Identifier
1245284124
Registry record updated Sep 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
KM048873 Issued in MI
Practice address
5694 Midland Rd
Freeland, MI 48623
Phone
(989) 695-2123
NPI assigned
May 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X KM048873 MI Primary

Addresses

Primary practice location

5694 Midland Rd
Freeland, MI 48623

Mailing address

5694 Midland Rd
Freeland, MI 48623-8845
Phone (989) 695-2123

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060504000688 MI Practitioner - Family Practice 9537115365 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wayne State University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mymichigan Medical Center MidlandGroup PAC ID 2264323633, 507 clinicians

Practice addresses (Care Compare)

5694 Midland Rd
Freeland, MI 48623-8845
Phone (989) 695-4950

Hospital & facility affiliations

  • Mymichigan Medical Center Midland Hospital, Midland, MI, CCN 230222
  • Mymichigan Medical Center Gladwin Hospital, Gladwin, MI, CCN 231325
  • Mymichigan Medical Center Clare Hospital, Clare, MI, CCN 230180

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
KM048873MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Gladwin CurrentSince Jan 1, 2016 Accepting new patients
Mymichigan Medical Center Midland CurrentSince Jul 1, 2015 Accepting new patients
Mymichigan Medical Center Alma Family Medicine CurrentSince Dec 31, 2017 Accepting new patients
Mymichigan Medical Center Alpena Current Accepting new patients
Mymichigan Medical Center Midland Family Medicine CurrentSince Jul 1, 2015 Accepting new patients
Mymichigan Medical Center Alma Family Medicine CurrentSince Dec 31, 2017 Accepting new patients
Mymichigan Medical Center Gladwin CurrentSince Jan 1, 2016 Accepting new patients
Mymichigan Medical Center Alpena CurrentSince Sep 4, 2025 Accepting new patients
Mymichigan Medical Center Clare CurrentSince Dec 31, 2017 Accepting new patients
Mymichigan Medical Center Alma Current Accepting new patients
Midmichigan Urgent Care Family Medicine Past Accepting new patients
Mymichigan Medical Center Clare Past Accepting new patients
Mymichigan Medical Center Alma Past Accepting new patients
Henderson County Hospital Corporation Family Medicine Past Accepting new patients

Locations

321 E Warwick Dr
Alma, MI 48801
Phone (989) 463-0957

393 Long Rapids Rd
Alpena, MI 49707
Phone (989) 354-4406

1501 W Chisholm St
Alpena, MI 49707
Phone (989) 356-7000

2980 Wilder Rd
Ste B
Bay City, MI 48706
Phone (989) 509-3333

700 W 5th St
Clare, MI 48617
Phone (989) 386-9911

602 Beech St
Ste 1100
Clare, MI 48617
Phone (989) 386-9911

5694 Midland Rd
Freeland, MI 48623
Phone (989) 695-2123

609 Quarter St
Gladwin, MI 48624
Phone (989) 246-6371

1105 E Cedar Ave
Gladwin, MI 48624
Phone (989) 246-6490

515 Quarter St
Gladwin, MI 48624
Phone (989) 246-6201

815 N Clare Ave
Harrison, MI 48625
Phone (989) 539-4096

4500 N Campus Ridge Dr
Midland, MI 48640
Phone (989) 837-9250

2618 W Sugnet Rd
Midland, MI 48640
Phone (989) 633-5237

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

3009 N Saginaw Rd
Midland, MI 48640
Phone (989) 633-1350

555 W Wackerly St
Ste 1600
Midland, MI 48640
Phone (989) 374-0131

3009 N Saginaw Rd
#C
Midland, MI 48640
Phone (989) 633-1350

640 Court St
West Branch, MI 48661
Phone (989) 343-3730

Interoperability endpoints

  • Direct secure messaging: kmackinnon6692@mymichiganhealth.midirect.net

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 14

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346889600000",
    "number": "1245284124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5694 MIDLAND RD",
            "city": "FREELAND",
            "state": "MI",
            "postal_code": "486238845",
            "telephone_number": "989-695-2123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5694 MIDLAND RD",
            "city": "FREELAND",
            "state": "MI",
            "postal_code": "48623",
            "telephone_number": "989-695-2123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKINNON",
        "first_name": "KENNETH",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2012-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "KM048873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeland, MI

Sources for this page

Verify at the official NPI Registry.