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CRYSTAL LAKE CLINIC, P.C.
NPI 1417386145
Family Medicine in Empire, MI

Active since November 04, 2013
9975 W OTTAWA AVE, EMPIRE, MI 49630(231) 882-9616 Get Directions Write a Review

NPPES record last updated: November 4, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Crystal Lake Clinic, P.c. NPPES

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

CRYSTAL LAKE CLINIC, P.C. (NPI 1417386145) is a healthcare organization registered as a family medicine in Empire, Michigan and active in the NPI registry since November 2013. The organization lists Richard Nielsen, President, as its authorized official.

NPPES Registry Identity

NPI1417386145
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameCRYSTAL LAKE CLINIC, P.C.
Location Address9975 W OTTAWA AVEEmpire, MI 49630-9618
Mailing Address6227 Frankfort HwyBenzonia, MI 49616-8632 · (231) 882-9661 · Fax (231) 882-9616
Phone(231) 882-9616
Organization SubpartNo
Authorized OfficialRichard NielsenPresident · (231) 882-9661
Enumeration DateNovember 4, 2013
✔ NPI 1417386145 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.

9975 W OTTAWA AVE, Empire, MI 49630
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Other Identifiers 1

Medicare PIN0N38430MI

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

Other Providers at the Same Location NPPES 5

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

PAUL OLIVER MEMORIAL HOSPITAL
Clinic/Center (Rural Health)
9975 W OTTAWA AVE
EMPIRE, MI 49630
Leelanau County (231) 835-2088
KATHRYN F KREZOSKI-EVANS D.O.
Family Medicine
9975 W OTTAWA AVE
EMPIRE, MI 49630
Leelanau County (231) 835-2088
CYRUS A GHAEMI D.O.
Family Medicine
9975 W OTTAWA AVE
EMPIRE, MI 49630
Leelanau County (231) 835-2088
DR. GLEN DOUGLAS MACPHERSON M.D.
Preventive Medicine (Aerospace Medicine)
9975 W OTTAWA AVE
EMPIRE, MI 49630
Leelanau County (231) 835-2088
MANITOU MEDICAL CENTER
Family Medicine
9975 W OTTAWA AVE
EMPIRE, MI 49630
Leelanau County (231) 326-2300

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, P.C.'s NPI number?

The NPI number for Crystal Lake Clinic, P.C. is 1417386145. It was assigned to this organization in the NPPES registry on November 4, 2013.

Where is Crystal Lake Clinic, P.C. located?

Crystal Lake Clinic, P.C. is located at 9975 W Ottawa Ave, Empire, MI 49630. The listed phone number is (231) 882-9616.

What is Crystal Lake Clinic, P.C.'s specialty?

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

When was this NPI record last updated?

The NPPES record for Crystal Lake Clinic, P.C. was last updated on November 4, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.