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CRYSTAL LAKE CLINIC PC
NPI 1134491731
Family Medicine in Manistee, MI

Active since January 30, 2012
1806 E PARKDALE AVE STE 2, MANISTEE, MI 49660(231) 882-9661 Get Directions Write a Review

NPPES record last updated: January 30, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Crystal Lake Clinic Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CRYSTAL LAKE CLINIC PC (NPI 1134491731) is a healthcare organization registered as a family medicine in Manistee, Michigan and active in the NPI registry since January 2012. The organization lists Richard Nielsen, President, as its authorized official.

NPPES Registry Identity

NPI1134491731
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameCRYSTAL LAKE CLINIC PC
Location Address1806 E PARKDALE AVE STE 2Manistee, MI 49660-9364
Mailing Address6227 Frankfort HwyBenzonia, MI 49616-8632 · (231) 882-9661 · Fax (231) 882-9616
Phone(231) 882-9661
Organization SubpartNo
Authorized OfficialRichard NielsenPresident · (231) 882-9661
Enumeration DateJanuary 30, 2012
✔ NPI 1134491731 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
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.
1806 E PARKDALE AVE STE 2, Manistee, MI 49660
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Crystal Lake Clinic PC's NPI number?

The NPI number for Crystal Lake Clinic PC is 1134491731. It was assigned to this organization in the NPPES registry on January 30, 2012.

Where is Crystal Lake Clinic PC located?

Crystal Lake Clinic PC is located at 1806 E Parkdale Ave Ste 2, Manistee, MI 49660. The listed phone number is (231) 882-9661.

What is Crystal Lake Clinic PC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

What insurance does Crystal Lake Clinic PC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Crystal Lake Clinic PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Crystal Lake Clinic PC was last updated on January 30, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.