BAYSIDE FAMILY & SPORTS MEDICINE PC


Address: 2325 Summit Park Dr, Suite 3, Petoskey, MI 49770-8774
Phone: 2314395100

BAYSIDE FAMILY & SPORTS MEDICINE PC (NPI# 1629251129) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1629251129
Entity Type Organization
Organization Name BAYSIDE FAMILY & SPORTS MEDICINE PC
Other Organization Name BAYSIDE FAMILY & SPORTS MEDICINE PC
Practice Address 2325 Summit Park Dr
Suite 3
Petoskey
MI 49770-8774
Practice Telephone 2314395100
Practice Fax Number 2314399292
Mailing Telephone 2314395100
Mailing Fax Number 2314399292
Enumeration Date 2007-12-07
Last Update Date 2012-04-10
Authorized Official Name TODD EDWARD DECKER (OWNER/PRESIDENT)
Authorized Official Telephone 2314395100
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Q00000X Family Medicine Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
Bayside Family & Sports Medicine PC Other Name - Individual/Organization

Office Location

Street Address 2325 SUMMIT PARK DR
SUITE 3
City PETOSKEY
State MI
Zip Code 49770-8774

Providers in the same location

NPI Name Taxonomy Address Enumeration
1568456028 Robert Scott Sheperd Dentist 2325 Summit Park Dr, Suite D, Petoskey, MI 49770-8774 2005-09-09
1346625738 Michelle Lee Beigle Clinical Nurse Specialist 2325 Summit Park Dr, Suite 3, Petoskey, MI 49770-8774 2015-07-27
1235577180 Amy Cullen Audiologist 2325 Summit Park Dr, Suite B, Petoskey, MI 49770-8774 2013-06-12
1134345036 Timothy S. Jarvi Md PC Technician/Technologist 2325 Summit Park Dr, Suite A, Petoskey, MI 49770-8685 2007-04-18
1871600676 Todd Edward Decker Family Medicine 2325 Summit Park Dr, Suite 3, Petoskey, MI 49770-8774 2006-08-25
1679597785 Todd M Sheperd Family Medicine 2325 Summit Park Dr, Suite 3, Petoskey, MI 49770-8774 2006-07-26
1164449765 Lisa M Hoffman Nurse Practitioner 2325 Summit Park Dr, Suite 3, Petoskey, MI 49770-8774 2006-07-17
1124053954 Debra Lin Denton-carlson Optometrist 2325 Summit Park Dr, Petoskey, MI 49770-8774 2006-07-11
1770517120 Timothy Scott Jarvi Ophthalmology 2325 Summit Park Dr, Petoskey, MI 49770-8685 2006-07-10
1821028846 Timothy S Jarvi Md PC Ophthalmology 2325 Summit Park Dr, Petoskey, MI 49770-8685 2006-07-04
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1780231985 Olivia Michelle Seaman Pharmacist 1301 U.S. 31 N. Hwy, Petoskey, MI 49770 2019-08-22
1649733148 Harbor Hall, Inc. Clinic/Center 302 Orchard Ridge Drive, Petoskey, MI 49770 2019-04-11
1053802942 Devin Hueston Dentist 231 State St Ste 3, Petoskey, MI 49770 2018-05-25
1720585037 Jacob Kenneth Tracy Counselor 410 E Lake Street, Suite 100, Petoskey, MI 49770 2018-04-12
1013424191 Timothy Robert La Gasse Nurse Practitioner 401 Connable Ave, Petoskey, MI 49770 2018-01-10
1609303676 Shauna Sue Stark Nurse Practitioner 560 W Mitchell St Ste 505, Petoskey, MI 49770 2017-05-22
1053851519 Maureen Todd Counselor 703 Emmet St, Petoskey, MI 49770 2017-03-03
1457719239 Hufford Vision & Eye Care, PC Optometrist 560 West Mitchell, Suite 214, Petoskey, MI 49770 2016-02-08
1053779439 Kaylyn Schiemann Specialist/Technologist 1980 Maxwell Rd, Petoskey, MI 49770 2016-02-01
1669839130 Stieber Pediatric Dentistry Pllc Clinic/Center 1605 Us 131 Highway, Petoskey, MI 49770 2016-01-28
Find all providers in zip 49770

Taxonomy Information

Taxonomy Code 207Q00000X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine

Taxonomy Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition]
- Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences.
- Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1801364005 Northern Family Medicine, Pllc Family Medicine 2810 Charlevoix Rd Ste 104, Petoskey, MI 49770-8421 2018-11-06
1861811382 Petoskey Urgent Care Billing PC Family Medicine 1890 S Us Highway 131 Unit 4, Petoskey, MI 49770-8344 2014-04-11
1235301201 Jane K. Harris Family Medicine 424 Petoskey St, Petoskey, MI 49770-2618 2008-03-30
1023192564 Suzanne Wehrenberg Family Medicine 4048 Cedar Bluff Drive, Suite 5, Petoskey, MI 49770-8895 2006-10-24
1184682924 Carin L. Nielsen Family Medicine 107 Howard Street, Suite A, Petoskey, MI 49770 2006-05-02
1518922988 Richard W Mansfield Family Medicine 1937 M 119, Petoskey, MI 49770-8913 2006-04-19
1093703548 Petoskey Family Medicine P.C. Family Medicine 1890 S Us 131, Suite 3, Petoskey, MI 49770-8344 2005-10-10
1548266158 Shawn M Pertunen Family Medicine 2390 Mitchell Park Dr, Petoskey, MI 49770-8965 2005-06-28
1326459116 Boyne Country Urgent Care Family Medicine 1937 M 119, Petoskey, MI 49770-8913 2014-05-14
1578995775 Indigo Hospital Medicine - Petoskey, Plc Family Medicine 416 Connable Ave, Petoskey, MI 49770-2212 2013-07-30
Find all providers in PETOSKEY

Competitor

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City PETOSKEY
Zip Code 49770

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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