McLaren Caro Region

Organization Active NPI Rural Health Clinic/Center · Caro, MI

NPI 1407477136 · NPPES record last updated Nov 14, 2024

Key facts

NPI
1407477136
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
MCLAREN CARO REGION
Practice address
465 N Hooper St
Caro, MI 48723-1406
Phone
(989) 672-5735
Fax
(989) 672-5736
NPI assigned
May 5, 2020
Organization subpart
No

Authorized official

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

Other NPIs with the same Medicare PAC ID 3

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

Corporate family (same tax ID) 3

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

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

Facilities with the same owner 58

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

View all 58

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI

Rural health clinic certification: CCN 238748

Legal name
MCLAREN CARO REGION
Doing business as
MCLAREN CARO HILL BUILDING
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 25, 2020
Last certification
Nov 25, 2020
Ownership / control type
2B
Organization structure
Corporation · Non-profit
Enrollment address
465 N Hooper St
Caro, MI 48723-1406
Related CCNs
231329

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Kenneth E Baranski
Individual
Corporate Officer
VP/Cfo
Mar 27, 2024
W-2 Managing Employee
VP/Cfo
Mar 27, 2024
Operational/Managerial Control
VP/Cfo
Mar 27, 2024
Chad Grant
Individual
Corporate Director
Coo & MHC Corp Designee
Aug 7, 2021
Lainey Ransford
Individual
Corporate Director
Trustee
Jan 1, 2014
Connie Koutouzos
Individual
Corporate Officer
President/Ceo
Nov 15, 2021
W-2 Managing Employee
President/Ceo
Nov 15, 2021
Operational/Managerial Control
President/Ceo
Nov 15, 2021
John Hunter
Individual
Corporate Director
Trustee
Jan 1, 2014
McLaren Health Care Corporation
Organization · Grand Blanc, MI
Corporation, Non-profit, Chain home office
5% Or Greater Direct Ownership Interest Jan 26, 2018 100%
Robert Wolak
Individual
Corporate Director
Director
Apr 1, 2014
Jonathan Cummings
Individual
Corporate Director
Trustee
Jun 11, 2026
Robert Fulton
Individual
Corporate Director
Trustee
Nov 15, 2021
Brant Wilson
Individual
Corporate Director
Trustee
Feb 1, 2019

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20200707000664 MI Part a Provider - Rural Health Clinic 9234048166 Practice locations: Caro, MI

National Provider Directory

Tax ID family
McLaren Caro Region (4 organizations share this tax ID)

Specialties & licenses

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

Addresses

Primary practice location

465 N Hooper St
Caro, MI 48723-1406

Mailing address

PO Box 435
Caro, MI 48723-0435
Phone (989) 672-5800

Other names

  • McLaren Caro Region Doing business as
  • McLaren Caro Hill Building Other name

Other providers in Caro, MI

All providers in Caro, MI · Rural Health Clinic/Center in Michigan

Sources for this page

Verify at the official NPI Registry.