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CRYSTAL LAKE CLINIC, PC
NPI 1306190475
Family Medicine in Manton, MI

Active since October 29, 2012
115 E 7TH ST, MANTON, MI 49663(231) 824-4100(231) 824-4108 Get Directions Write a Review

NPPES record last updated: October 29, 2012. Verified against the NPPES registry weekly; last sync: August 09, 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 1306190475) is a healthcare organization registered as a family medicine in Manton, Michigan and active in the NPI registry since October 2012. The organization lists Richard C Nielsen, President, as its authorized official.

NPPES Registry Identity

NPI1306190475
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameCRYSTAL LAKE CLINIC, PC
Location Address115 E 7TH STManton, MI 49663-9429
Mailing Address6227 Frankfort HwyBenzonia, MI 49616-8632 · (231) 882-9661 · Fax (231) 882-9616
Phone(231) 824-4100
Fax(231) 824-4108
Organization SubpartNo
Authorized OfficialRichard C NielsenPresident · (231) 882-9661
Enumeration DateOctober 29, 2012
✔ NPI 1306190475 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.
115 E 7TH ST, Manton, MI 49663
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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 ›

Other Providers at the Same Location NPPES 3

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

MANTON MEDICAL CENTER PC
Clinic/Center (Rural Health)
115 E 7TH ST
MANTON, MI 49663
Wexford County (231) 824-9672
EMILY LAUREN MOSES P.A.
Physician Assistant (Medical)
115 E 7TH ST
MANTON, MI 49663
Wexford County (231) 824-4100
MANTON HEALTH CENTER,P LLC
Family Medicine
115 E 7TH ST
MANTON, MI 49663
Wexford County (231) 715-6131

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 1306190475. It was assigned to this organization in the NPPES registry on October 29, 2012.

Where is Crystal Lake Clinic, PC located?

Crystal Lake Clinic, PC is located at 115 E 7th St, Manton, MI 49663. The listed phone number is (231) 824-4100.

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 October 29, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.