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ALPINE FAMILY MEDICINE PLC
NPI 1174577720
Family Medicine in Gaylord, MI

Active since May 19, 2006CLIA 23D0381657 · Microscopy
652 N OTSEGO AVE, GAYLORD, MI 49735(989) 732-3529(989) 732-7865 Get Directions Write a Review

NPPES record last updated: January 6, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Alpine Family Medicine Plc NPPES

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

ALPINE FAMILY MEDICINE PLC (NPI 1174577720) is a healthcare organization registered as a family medicine in Gaylord, Michigan and active in the NPI registry since May 2006. The organization holds a CLIA Microscopy certificate valid through August 31, 2026 and lists Derek David Olson, Md/owner, as its authorized official.

NPPES Registry Identity

NPI1174577720
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameALPINE FAMILY MEDICINE PLC
Location Address652 N OTSEGO AVEGaylord, MI 49735-2502
Mailing Address652 N Otsego AveGaylord, MI 49735-2502 · (989) 732-3529 · Fax (989) 732-7865
Phone(989) 732-3529
Fax(989) 732-7865
Organization SubpartNo
Authorized OfficialDerek David OlsonMd/owner · (989) 732-3529
Enumeration DateMay 19, 2006
Last NPPES UpdateJanuary 6, 2021
NPPES CertifiedJanuary 6, 2021
✔ NPI 1174577720 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MI · KK030249
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.
652 N OTSEGO AVE, Gaylord, MI 49735
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE 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 ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 23D0381657

Alpine Family Medicine · Gaylord, MI
Active · expires Aug 31, 2026
CLIA Number23D0381657
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorDerek D. Olson
Laboratory Phone(989) 732-3529
Laboratory LocationAlpine Family Medicine652 North Otsego, Gaylord, MI 49735
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. DOMINIC JEROME GIALLOMBARDO MT(ASCP), RN, PA-C
Physician Assistant
652 N OTSEGO AVE
GAYLORD, MI 49735
Otsego County (989) 732-3529
ASHLEY A GROTERS NP
Nurse Practitioner
652 N OTSEGO AVE
GAYLORD, MI 49735
Otsego County (989) 732-3529
DR. DEREK DAVID OLSON M.D.
Family Medicine (Sports Medicine)
652 N OTSEGO AVE
GAYLORD, MI 49735
Otsego County (989) 732-3529
DR. KAREN SUE KOBY-OLSON M.D.
Pediatrics
652 N OTSEGO AVE
GAYLORD, MI 49735
Otsego County (989) 732-3529

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 Alpine Family Medicine Plc's NPI number?

The NPI number for Alpine Family Medicine Plc is 1174577720. It was assigned to this organization in the NPPES registry on May 19, 2006.

Where is Alpine Family Medicine Plc located?

Alpine Family Medicine Plc is located at 652 N Otsego Ave, Gaylord, MI 49735. The listed phone number is (989) 732-3529.

What is Alpine Family Medicine Plc's specialty?

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

Does Alpine Family Medicine Plc hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 23D0381657) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Alpine Family Medicine Plc 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 Alpine Family Medicine Plc 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 Alpine Family Medicine Plc was last updated on January 6, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.