NPIMap

Organization Active NPI

McKenzie Memorial Hospital

Doing business as McKenzie Health System

  • Critical Access Hospital
  • Sandusky, MI
National Provider Identifier
1497750608
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
760030 Issued in MI
Legal business name
MCKENZIE MEMORIAL HOSPITAL
Doing business as
McKenzie Health System
Practice address
120 N Delaware St
Sandusky, MI 48471-1009
Phone
(810) 648-6162
Fax
(810) 648-5058
NPI assigned
Jun 15, 2005
Last updated
Oct 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Authorized official

Name
Mrs. Amy Ruedisueli
Title
V.P. Finance
Phone
(810) 648-6162

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X 1060000096 MI
Medicare Defined Swing Bed Hospital Unit 275N00000X MI06100 MI
Critical Access Hospital 282NC0060X 760030 MI Primary

Addresses

Primary practice location

120 N Delaware St
Sandusky, MI 48471-1009

Mailing address

120 N Delaware St
Sandusky, MI 48471-1009
Phone (810) 648-6162

Other names 1

  • McKenzie Health System Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040310000552 MI Part B Supplier - Clinic/Group Practice 6406755289 Receives reassigned benefits from 54 practitioners
2 other NPIs on this enrollment
Practice locations: Port Sanilac, MI; Sandusky, MI; Croswell, MI
O20070815000307 MI Part A Provider - Critical Access Hospital 6406755289 Receives reassigned benefits from 29 practitioners
1 other NPI on this enrollment
Practice locations: Croswell, MI; Peck, MI; Sandusky, MI
O20220524002006 MI Part A Provider - Critical Access Hospital 6406755289 Practice locations: Sandusky, MI

NPI to CCN mapping 3

The Medicare certification numbers (CCNs) connected to NPI 1497750608. Details of each certification follow.

Hospital certification: CCN 231314

Legal name
MCKENZIE MEMORIAL HOSPITAL
Doing business as
MCKENZIE HEALTH SYSTEM
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Oct 1, 2002
Last certification
Dec 18, 2024
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
120 N Delaware St
Sandusky, MI 48471-1009
Other Hospital Practice Location

Hospital certification: CCN 23Z314

Legal name
MCKENZIE MEMORIAL HOSPITAL
Doing business as
MCKENZIE HEALTH SYSTEM
Organization structure
CorporationNon-profit
Enrollment address
120 N Delaware St
Sandusky, MI 48471-1009
Other Hospital Practice Location

Hospital certification: CCN 230253

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
MCKENZIE MEMORIAL HOSPITAL
Certification status
Terminated Other: provider status change, Oct 1, 2002
Provider type (POS)
Hospital – Short-term
Participating since
Jun 26, 1967
Last certification
Oct 26, 2000
Beds
37
Ownership / control type
Private (not for profit)
Facility address
120 Delaware Street
Sandusky, MI 48471

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

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
McKenzie Health SystemCCN 231314 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
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
23D0668762McKenzie Health System120 N Delaware Street, Sandusky, MI 48471AccreditationMay 10, 2028
23D2156001McKenzie Health System - Walk in Clinic120 Delaware Street, Sandusky, MI 48471Certificate of waiverOct 8, 2026

National Provider Directory

National Provider Directory

Member organizations 1

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

Locations

100 W Argyle St
#1
Sandusky, MI 48471
Phone (810) 648-6162

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Larry Mitchell Individual Corporate Director Feb 1, 2009
Michael Dreyer Individual Corporate Director Aug 1, 2010
Billi Jo Hennika Individual W-2 Managing Employee May 1, 2013
Corporate OfficerChief Operating Officer May 1, 2013
W-2 Managing EmployeeChief Operating Officer May 1, 2013
Tonya Kaufman Individual Corporate Director Nov 28, 2023
Amy Ruedisueli Individual Corporate Officer Jul 9, 2011
W-2 Managing Employee Jul 9, 2011
Corporate OfficerChief Financial Officer Jul 28, 2006
W-2 Managing Employee Aug 13, 2007
James L Sams Individual Corporate Director Jan 1, 2017
Steve Barnett Individual W-2 Managing Employee May 12, 2008
Corporate OfficerChief Executive Officer May 12, 2008
W-2 Managing EmployeeChief Executive Officer May 12, 2008
Brandon Guibord Individual Corporate Director Jun 28, 2022
Matthew D Gormley Individual Corporate Director Jan 1, 2019
Joan Nagelkirk Individual Corporate Director Jun 12, 2017
Orin Earl Campbell Individual Corporate Director Jul 9, 2018

Owners & managing parties with NPI records 2

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

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
McKenzie Health & WellnessSandusky, MI, CCN 238759 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2020
Peck Medical CenterPeck, MI, CCN 238777 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2024
McKenzie Family HealthcareSandusky, MI, CCN 238776 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2024

Owned or controlled facilities with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 55

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 55

Affiliated clinicians 112

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

View all 112

NPI Registry JSON

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761004800000",
    "number": "1497750608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 N DELAWARE ST",
            "city": "SANDUSKY",
            "state": "MI",
            "postal_code": "484711009",
            "telephone_number": "810-648-6162",
            "fax_number": "810-648-5058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N DELAWARE ST",
            "city": "SANDUSKY",
            "state": "MI",
            "postal_code": "484711009",
            "telephone_number": "810-648-6162",
            "fax_number": "810-648-5058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCKENZIE MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-15",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A",
        "authorized_official_last_name": "RUEDISUELI",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "V.P. FINANCE",
        "authorized_official_telephone_number": "810-648-6162",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "1060000096",
            "primary": false
        },
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "MI",
            "license": "MI06100",
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "MI",
            "license": "760030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McKenzie Health System",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sandusky, MI

Sources for this page

Verify at the official NPI Registry.