Mackinaw Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

MACKINAW SURGERY CENTER LLC

Practice address

5400 Mackinaw Rd
Saginaw, MI 48604

Phone

(636) 220-8597

NPI assigned

Dec 19, 2006

Organization subpart

No

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

Authorized official

Name

Lisa Kenny

Title

Administrator

Phone

(989) 583-5205

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Listed as

Mackinaw Surgery Center LLCCCN 23C0001082

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Covenant Medical Center, Inc.

  • Certified Registered Nurse Anesthetist
  • Saginaw, MI
  • NPI 1225151897

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684713600000",
    "number": "1780747733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 MACKINAW RD STE 11",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486049545",
            "telephone_number": "989-583-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 MACKINAW RD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "48604",
            "telephone_number": "636-220-8597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACKINAW SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A",
        "authorized_official_last_name": "KENNY",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "989-583-5205"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Savannah Machul
• William David Macinnes, PH.D.
• Sonya Ann Mack, RD, CNSD
• Holly Mackay
• Mackinaw Street Pharmacy LLC
• Kathryn Christin Mackinnon
• Katharine E Macmillan, DO
• Marcus Macnealy, MD
• Grace Elizabeth Macomber, MSW
• Lakshmana R Madala, M.D.

• Ambulatory Surgical Clinic/Center in Saginaw, MI
• Providers in Saginaw, MI by specialty
• Ambulatory Surgical Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.