NPIMap

Organization Active NPI

McLaren Northern Michigan

  • Psychiatric Hospital Unit
  • Cheboygan, MI
National Provider Identifier
1336897735
Registry record updated Mar 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
Legal business name
MCLAREN NORTHERN MICHIGAN
Practice address
748 S Main St
Cheboygan, MI 49721-2220
Phone
(231) 627-5601
NPI assigned
Mar 15, 2022
Last updated
Mar 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2022

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

Authorized official

Name
Michael Prusaitis
Title
Cfo
Phone
(559) 450-3375

Specialties & licenses 1

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

Addresses

Primary practice location

748 S Main St
Cheboygan, MI 49721-2220

Mailing address

748 S Main St
Cheboygan, MI 49721-2220
Phone (231) 627-5601

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20030319000000 MI Part A Provider - Hospital 9931018181 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Petoskey, MI; Gaylord, MI; Cheboygan, MI
O20230926000761 MI Part A Provider - Hospital 9931018181 Practice locations: Cheboygan, MI

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1336897735. Details of each certification follow.

Hospital certification: CCN 230105

Legal name
MCLAREN NORTHERN MICHIGAN
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jun 1, 1977
Last certification
Oct 31, 2015
Beds
243 (229 certified)
Ownership / control type
Other
Organization structure
CorporationNon-profit
Enrollment address
416 Connable Ave
Petoskey, MI 49770-2212
Main/Primary Hospital Location
Hospital subgroups
Acute care

Hospital certification: CCN 23S105

Legal name
MCLAREN NORTHERN MICHIGAN
Organization structure
CorporationNon-profit
Enrollment address
748 S Main St
Cheboygan, MI 49721-2220
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

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 Northern MichiganCCN 230105 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Other
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

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
23D0381622McLaren Northern Michigan Cheboygan748 S Main Street, Cheboygan, MI 49721AccreditationJan 2, 2027

National Provider Directory

National Provider Directory
Tax ID family
No Mi Hosprogers City4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

14730 Park Ave
Bldg B
Charlevoix, MI 49720
Phone (231) 547-6510

740 S Main St
Ste 1C
Cheboygan, MI 49721
Phone (855) 480-2490

740 S Main St
Ste 2B
Cheboygan, MI 49721
Phone (231) 627-1326

740 S Main St
Ste 2MCPC
Cheboygan, MI 49721
Phone (231) 627-1282

740 S Main St
Ste 3C
Cheboygan, MI 49721
Phone (855) 480-2490

740 S Main St
Ste 3MCPC
Cheboygan, MI 49721
Phone (231) 627-1493

560 W Mitchell St
Ste 101
Petoskey, MI 49770
Phone (231) 487-4000

560 W Mitchell St
Ste 170A
Petoskey, MI 49770
Phone (231) 487-3590

560 W Mitchell St
Ste 300
Petoskey, MI 49770
Phone (231) 487-2460

560 W Mitchell St
Ste 330
Petoskey, MI 49770
Phone (231) 487-3390

560 W Mitchell St
Ste 508
Petoskey, MI 49770
Phone (231) 487-5338

560 W Mitchell St
Ste M50
Petoskey, MI 49770
Phone (231) 487-2111

820 Arlington Ave
#228
Petoskey, MI 49770
Phone (231) 487-4000

820 Arlington Ave
#258
Petoskey, MI 49770
Phone (231) 487-4000

820 Arlington Ave
Rm 214
Petoskey, MI 49770
Phone (231) 487-4685

820 Arlington Ave
Rm 228
Petoskey, MI 49770
Phone (231) 487-4200

820 Arlington Ave
Rm 233
Petoskey, MI 49770
Phone (231) 487-4200

820 Arlington Ave
Rm 250
Petoskey, MI 49770
Phone (231) 487-4000

820 Arlington Ave
Rm 254
Petoskey, MI 49770
Phone (231) 487-4000

820 Arlington Ave
Rm 258
Petoskey, MI 49770
Phone (231) 487-3200

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Christine Gebhard Individual Corporate DirectorTrustee Jan 30, 2025
Matthew Frentz Individual Corporate DirectorTrustee Feb 1, 2021
Patricia Hemingway Hall Individual Corporate DirectorTrustee Feb 1, 2021
Chad Grant Individual Corporate DirectorCoo & MHC Corp Designee Aug 7, 2021
Craig Rogerson Individual Corporate DirectorTrustee Mar 1, 2023
Michael Loria Individual Corporate DirectorTrustee Jan 31, 2024
McLaren Health Care Corporation Organization, Grand Blanc, MI Non-profit, Chain home office 5% Or Greater Direct Ownership Interest Jan 1, 2012
Garfield H Atchison Individual Corporate OfficerPresident/Ceo Dec 20, 2023
Corporate DirectorPresident/Ceo Dec 20, 2023
Operational/Managerial ControlPresident/Ceo Dec 20, 2023
Corporate DirectorTrustee Dec 20, 2023
Arthur Hailand Individual Corporate DirectorTrustee Oct 28, 2024
Julie Fasone-Holder Individual Corporate DirectorTrustee Feb 1, 2017
Michael Prusaitis Individual Corporate OfficerCfo Mar 29, 2021
W-2 Managing EmployeeCfo Mar 29, 2021
Operational/Managerial ControlCfo Mar 29, 2021
Corporate OfficerCfo May 3, 2021
W-2 Managing EmployeeCfo May 3, 2021
Operational/Managerial ControlCfo May 3, 2021
Dennis Bryon Hesselink Individual Corporate DirectorTrustee Feb 1, 2017
Elise F Hayes Individual Corporate DirectorTrustee Feb 1, 2019
Thomas Cattel Individual Corporate DirectorTrustee Feb 1, 2019
McLaren Health Care Corporation Organization, Grand Blanc, MI Corporation, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Jan 1, 2012 100%

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Boulder Park TerraceCharlevoix, MI, CCN 235526 Skilled nursing facility 5% Or Greater Direct Ownership Interest (75%) Jan 1, 2013

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 201

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.

View all 201

Affiliated clinicians 431

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

View all 431

NPI Registry JSON

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

{
    "created_epoch": "1647302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647302400000",
    "number": "1336897735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "748 S MAIN ST",
            "city": "CHEBOYGAN",
            "state": "MI",
            "postal_code": "497212220",
            "telephone_number": "231-627-5601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "748 S MAIN ST",
            "city": "CHEBOYGAN",
            "state": "MI",
            "postal_code": "497212220",
            "telephone_number": "231-627-5601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLAREN NORTHERN MICHIGAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-15",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A",
        "authorized_official_last_name": "PRUSAITIS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "559-450-3375"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheboygan, MI

Sources for this page

Verify at the official NPI Registry.