NPIMap

Organization Active NPI

Mackinac Straits Health System Inc

Doing business as Mackinac Straits Hospital

  • Skilled Nursing Facility
  • Saint Ignace, MI
National Provider Identifier
1902061385
Registry record updated May 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MACKINAC STRAITS HEALTH SYSTEM INC
Doing business as
Mackinac Straits Hospital
Practice address
1140 N State St
Saint Ignace, MI 49781-1048
Phone
(906) 643-8585
Fax
(906) 643-0373
NPI assigned
Jul 24, 2008
Last updated
May 3, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2021

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

Authorized official

Name
Sonja Sprague
Title
Credentialing
Phone
(906) 643-0451

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

1140 N State St
Saint Ignace, MI 49781-1048

Mailing address

1140 N State St
Saint Ignace, MI 49781-1048
Phone (906) 643-8585

Other identifiers 3

IdentifierTypeStateIssuer
625356702MedicaidMI
09610OtherMIBLUE CROSS BLUE SHIELD
15223OtherMIBLUE CROSS BLUE SHIELD

Other names 1

  • Mackinac Straits Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080527000326 MI Part A Provider - Skilled Nursing Facility 1456420876 Practice locations: Saint Ignace, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902061385. Details of each certification follow.

Skilled nursing facility certification: CCN 235041

Legal name
MACKINAC STRAITS HEALTH SYSTEM INC
Doing business as
EVERGREEN LIVING CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1967
Last certification
May 29, 2025
Beds
48
Ownership / control type
Other Nonprofit
Organization structure
CorporationNon-profit
Incorporated
Aug 2, 2006 in MI
Enrollment address
1140 N State St
Saint Ignace, MI 49781-1048
Nursing home name
MACKINAC STRAITS LONG TERM CARE UNIT

Other NPIs with the same Medicare PAC ID 6

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Mackinac Straits Long Term Care UnitCCN 235041 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
5 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Other
Certified
Jan 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4847.5 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Mackinac Straits Health System12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Individual Adp of the SNF Jan 1, 2024
Susan H Strich Individual Corporate DirectorPost Chief of Staff Jun 1, 2018
Jason C Anderson Individual Corporate DirectorCfo Jun 6, 2008
Patrick Shannon Individual Corporate DirectorBoard Vice Chair Jun 6, 2008
Prentiss M Brown Individual Corporate DirectorBoard Member Feb 12, 2013
Mackinac Straits Health System Inc Organization, Saint Ignace, MI Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 1967 100%
Operational/Managerial Control Jan 1, 1967
Adp of the SNF Jul 5, 2008
Direct Ownership Interest Jan 1, 1967 100%
Kevin McElroy Individual Corporate DirectorChief Human Resources & Support Jan 2, 2013
James North Individual Corporate DirectorBoard Member Feb 12, 2013
Individual Adp of the SNF Jan 1, 2024
John D Moffat Individual Operational/Managerial Control Jan 1, 2024
Adp of the SNF Jan 1, 2024
Keith Massaway Individual Corporate DirectorBoard Member May 14, 2015
Steven Autore Individual Corporate DirectorChair Jun 6, 2008
Mark Elmblad Individual Corporate DirectorBoard Member May 14, 2015
Individual Adp of the SNF Jan 1, 2024
Karen Cheeseman Individual Corporate OfficerPresident & Ceo Jul 13, 2017
Corporate DirectorPresident & Ceo Jul 13, 2017
Adp of the SNF Jul 13, 2017
Lauren K Buhr Individual Corporate DirectorMedical Director Jan 1, 2024
Adp of the SNF Jan 1, 2024
Margaret Doud Individual Corporate DirectorBoard Member Jun 6, 2008
Richard Smith Individual Corporate DirectorBoard Member Jun 6, 2008

Owners & managing parties with NPI records 9

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

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1216857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620000000000",
    "number": "1902061385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 N STATE ST",
            "city": "SAINT IGNACE",
            "state": "MI",
            "postal_code": "497811048",
            "telephone_number": "906-643-8585",
            "fax_number": "906-643-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 N STATE ST",
            "city": "SAINT IGNACE",
            "state": "MI",
            "postal_code": "497811048",
            "telephone_number": "906-643-8585",
            "fax_number": "906-643-0373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACKINAC STRAITS HEALTH SYSTEM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-24",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A",
        "authorized_official_last_name": "SPRAGUE",
        "authorized_official_first_name": "SONJA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "906-643-0451"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "625356702",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "09610",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "15223",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mackinac Straits Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mackinac Straits Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Ignace, MI

Sources for this page

Verify at the official NPI Registry.