CRYSTAL LAKE CLINIC P.C. (NPI# 1770537748) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770537748 |
| Entity Type | Organization |
| Organization Name | CRYSTAL LAKE CLINIC P.C. |
| Practice Address |
826 Forest Ave Frankfort MI 49635-9003 |
| Mailing Address |
6227 Frankfort Hwy Benzonia MI 49616-9654 |
| Practice Telephone | 2313525285 |
| Mailing Telephone | 2318829661 |
| Mailing Fax Number | 2318829616 |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2011-01-27 |
| Authorized Official Name | RICHARD C NIELSEN (PRESIDENT) |
| Authorized Official Telephone | 2318829661 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386028769 | Crystal Lake Clinic P.C. | Family Medicine | 6170 Us Highway 31 N, Williamsburg, MI 49690-9306 | 2015-07-15 |
| 1417902057 | Crystal Lake Clinic P.C. | Pediatrics | 1975 Stirling Dr, Interlochen, MI 49643-9264 | 2006-05-23 |
| 1164945978 | Crystal Lake Clinic P.C. | Family Medicine | 650 S West Bay Shore Dr, Suttons Bay, MI 49682-9587 | 2017-07-24 |
| 1053780072 | Crystal Lake Clinic P.C. | Family Medicine | 124 Ames St, Elk Rapids, MI 49629-9449 | 2015-09-21 |
| 1679957617 | Crystal Lake Clinic P.C. | Family Medicine | 1225 W Front St, Suite C, Traverse City, MI 49684-2368 | 2015-07-18 |
| 1376927756 | Crystal Lake Clinic P.C. | Family Medicine | 4025 Chums Village Dr, Traverse City, MI 49685-6992 | 2015-07-15 |
| 1538543913 | Crystal Lake Clinic P.C. | Family Medicine | 1213 W Front St, Traverse City, MI 49684-2317 | 2015-07-15 |
| 1316991755 | Crystal Lake Clinic P.C. | Internal Medicine | 6227 Frankfort Hwy, Benzonia, MI 49616-9654 | 2006-05-20 |
| Street Address |
826 FOREST AVE |
| City | FRANKFORT |
| State | MI |
| Zip Code | 49635-9003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003276197 | Michaela Coffia | Nurse Practitioner | 826 Forest Ave, Frankfort, MI 49635-9003 | 2016-03-02 |
| 1245609833 | Kimberly Vandahm | Physician Assistant | 826 Forest Ave, Frankfort, MI 49635-9003 | 2015-09-24 |
| 1659385219 | Gerard J Mahoney | Family Medicine | 826 Forest Ave, Frankfort, MI 49635 | 2006-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780233767 | Dianna Kay | Technician | 102 Grove Place, Apt 1, Frankfort, MI 49635 | 2019-09-11 |
| 1477047348 | Hygea Home Health Care | Home Health | 119 Airport Rd, Frankfort, MI 49635 | 2018-06-14 |
| 1174911408 | Zachary Cole Peterson | Chiropractor | 615 Main St # 768, Frankfort, MI 49635 | 2015-01-09 |
| 1992806285 | Douglas James Coles | Family Medicine | 917 Main Street, Frankfort, MI 49635 | 2006-09-26 |
| 1083263701 | Third Coast Dental Group, Pllc | Dentist | 2266 Frankfort Hwy, Frankfort, MI 49635 | 2019-09-05 |
| 1437400587 | Celina Jo Comer | Nurse Practitioner | 917 Main St, Frankfort, MI 49635 | 2012-09-28 |
| 1851477277 | Dale Victor Wentzloff | Dentist | 218 Seventh St, Frankfort, MI 49635-0033 | 2006-10-27 |
| 1699824045 | Kevin Reed Nelson | Optometrist | 228 Bellows Avenue, Frankfort, MI 49635-2158 | 2007-01-08 |
| 1992735997 | Francisco Leon Deguia | Surgery | 801 Main St, Frankfort, MI 49635-2246 | 2006-07-04 |
| 1124685854 | Shirley Jean Tranquill | Massage Therapist | 345 Sylvan Rd, Frankfort, MI 49635-8520 | 2019-05-29 |
| Find all providers in zip 49635 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417565755 | Ghr Total Health and Consulting | Family Medicine | 11336 Mckenna Dr, Frankfort, IL 60423-8096 | 2020-07-22 |
| 1215459664 | Samantha Jain | Family Medicine | 21160 S La Grange Rd, Frankfort, IL 60423-2010 | 2017-07-07 |
| 1437679958 | Unity Healthcare, LLC | Family Medicine | 2002 West County Road 0 N/s, Frankfort, IN 46041 | 2017-06-26 |
| 1477915866 | Lauren Ramsey Ridderikhoff | Family Medicine | 1001 Leawood Dr Ste C, Frankfort, KY 40601-3375 | 2016-03-24 |
| 1841552080 | Alaka Subhash Waikar | Family Medicine | 1010 S Butternut Cir, Frankfort, IL 60423-2125 | 2012-06-13 |
| 1831458850 | Frankfort Urgent Care | Family Medicine | 101 Kings Daughters Dr, Ste B, Frankfort, KY 40601-4197 | 2012-05-11 |
| 1356619530 | Rosario Teano De Castro | Family Medicine | 558 Aberdeen Rd, Frankfort, IL 60423-9715 | 2011-12-02 |
| 1104151943 | Family Medicine Associates of Frankfort Pllc | Family Medicine | 111 Westridge Dr, Suite F, Frankfort, KY 40601-4448 | 2009-10-13 |
| 1487810107 | Zakia Naz | Family Medicine | 1258 Oak St Ste B, Frankfort, IN 46041-3378 | 2008-08-01 |
| 1003080870 | Kc Health Horizons, Inc. | Family Medicine | 8964 Raintree Ln, Frankfort, IL 60423-6606 | 2008-04-14 |
| Find all providers in FRANKFORT | ||||
Please comment or provide details below to improve the information on CRYSTAL LAKE CLINIC P.C..
| 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.