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McKenzie Memorial Hospital

Organization Active NPI Critical Access Hospital · Sandusky, MI

NPI 1497750608 · NPPES record last updated Oct 21, 2025

Key facts

NPI
1497750608
Entity type
Organization (NPI type 2)
Primary specialty
Critical Access Hospital 282NC0060X
License
760030 (MI)
Legal business name
MCKENZIE MEMORIAL HOSPITAL
Practice address
120 N Delaware St
Sandusky, MI 48471-1009
Phone
(810) 648-6162
Fax
(810) 648-5058
NPI assigned
Jun 15, 2005
Organization subpart
No

Authorized official

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

Owners & managing parties with NPI records 2

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

Owned or controlled facilities with NPI records 3

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

Other NPIs on the same Medicare enrollment 2

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

Other NPIs with the same Medicare PAC ID 4

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

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

Practitioners 55

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

View all 55

Affiliated clinicians 112

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

View all 112

Medicare Care Compare: Hospital

Listed as
McKenzie Health System CCN 231314
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0668762McKenzie Health System
120 N Delaware Street, Sandusky, MI 48471		AccreditationMay 10, 2028
23D2156001McKenzie Health System - Walk in Clinic
120 Delaware Street, Sandusky, MI 48471		Certificate of waiverOct 8, 2026

Medicare participation

Medicare fee-for-service enrollment
Enrolled (3 enrollments) in MI

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
Corporation · Non-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
Corporation · Non-profit
Enrollment address
120 N Delaware St
Sandusky, MI 48471-1009
Other Hospital Practice Location

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 Officer
Chief Operating Officer		 May 1, 2013
W-2 Managing Employee
Chief 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 Officer
Chief 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 Officer
Chief Executive Officer		 May 12, 2008
W-2 Managing Employee
Chief 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

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 & Wellness
Sandusky, MI · CCN 238759		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2020
Peck Medical Center
Peck, MI · CCN 238777		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2024
McKenzie Family Healthcare
Sandusky, MI · CCN 238776		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2024

Medicare enrollment records

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

National Provider Directory

Locations

109 N Delaware St
Sandusky, MI 48471
Phone (810) 648-4219

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

Specialties & licenses

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

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 identifiers

IdentifierTypeStateIssuer
405171190MedicaidMI
301555717MedicaidMI

Other names

  • McKenzie Health System Doing business as

Other providers in Sandusky, MI

All providers in Sandusky, MI · Critical Access Hospital in Michigan

Sources for this page

Verify at the official NPI Registry.