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KIDS CREEK CHILDRENS CLINIC PC
NPI 1649291832
Pediatrics in Traverse City, MI

Active since July 22, 2006CLIA Certified · 3 labs
5024 N ROYAL DR, TRAVERSE CITY, MI 49684(231) 935-0555(231) 935-0562 Get Directions Write a Review

NPPES record last updated: June 27, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kids Creek Childrens Clinic Pc NPPES

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

KIDS CREEK CHILDRENS CLINIC PC (NPI 1649291832) is a healthcare organization registered as a pediatrics in Traverse City, Michigan and active in the NPI registry since July 2006. The organization holds 3 active CLIA laboratory certificates and lists Angela Mullen, Practice Administrator, as its authorized official.

NPPES Registry Identity

NPI1649291832
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameKIDS CREEK CHILDRENS CLINIC PC
Location Address5024 N ROYAL DRTraverse City, MI 49684-9230
Mailing Address5024 N Royal DrTraverse City, MI 49684-9230 · (231) 935-0555 · Fax (231) 935-0562
Phone(231) 935-0555
Fax(231) 935-0562
Organization SubpartNo
Authorized OfficialAngela MullenPractice Administrator · (231) 935-0555
Enumeration DateJuly 22, 2006
Last NPPES UpdateJune 27, 2024
NPPES CertifiedJune 27, 2024
✔ NPI 1649291832 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
5024 N ROYAL DR, Traverse City, MI 49684
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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 3

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 of Waiver 23D0676310

Kids Creek Childrens Clinic · Traverse City, MI
Active · expires Sep 29, 2026
CLIA Number23D0676310
Laboratory TypePhysician Office
Certificate Effective DateSeptember 30, 2024
Certificate Expiration DateSeptember 29, 2026
Laboratory DirectorJames W. Robertson
Laboratory Phone(231) 935-0555
Laboratory LocationKids Creek Childrens Clinic5024 N Royal Drive, Traverse City, MI 49684
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 23D2147924

Kids Creek Children's Clinic · Kalkaska, MI
Active · expires Apr 30, 2028
CLIA Number23D2147924
Laboratory TypePhysician Office
Certificate Effective DateMay 1, 2026
Certificate Expiration DateApril 30, 2028
Laboratory DirectorJames W. Robertson
Laboratory Phone(231) 935-0555
Laboratory LocationKids Creek Children's Clinic513 S Cedar Street, Kalkaska, MI 49646
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 23D2216710

Kids Creek Children's Clinic · Beulah, MI
Active · expires Mar 15, 2027
CLIA Number23D2216710
Laboratory TypePhysician Office
Certificate Effective DateMarch 16, 2025
Certificate Expiration DateMarch 15, 2027
Laboratory DirectorJames W. Robertson
Laboratory Phone(231) 935-0555
Laboratory LocationKids Creek Children's Clinic269 N Michigan Avenue, Beulah, MI 49617
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

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

CYNTHIA SMITH MD
Pediatrics
5024 N ROYAL DR
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 935-0555
MIRANDA BUIST FNP-C
Nurse Practitioner (Family)
5024 N ROYAL DR
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 935-0555
REBECCA ELAINE BAKER CPNP
Registered Nurse
5024 N ROYAL DR
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 935-0555
DR. JAMES WALLACE ROBERTSON MD
Pediatrics
5024 N ROYAL DR
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 935-0555
ALICIA CLASSENS CPNP
Nurse Practitioner (Pediatrics)
5024 N ROYAL DR, KIDS CREEK CHILDREN'S CLINIC
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 935-0555
SPECTRUM HEALTH PRIMARY CARE PARTNERS
Pediatrics (Pediatric Endocrinology)
5024 N ROYAL DR
TRAVERSE CITY, MI 49684
Grand Traverse County (616) 391-3933
JOAN ELIZABETH HAZELTON LMSW
Social Worker (Clinical)
5024 N ROYAL DR, STE B
TRAVERSE CITY, MI 49684
Grand Traverse County (231) 920-6145

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 Kids Creek Childrens Clinic PC's NPI number?

The NPI number for Kids Creek Childrens Clinic PC is 1649291832. It was assigned to this organization in the NPPES registry on July 22, 2006.

Where is Kids Creek Childrens Clinic PC located?

Kids Creek Childrens Clinic PC is located at 5024 N Royal Dr, Traverse City, MI 49684. The listed phone number is (231) 935-0555.

What is Kids Creek Childrens Clinic PC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Kids Creek Childrens Clinic PC hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Kids Creek Childrens 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 Kids Creek Childrens 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 Kids Creek Childrens Clinic PC was last updated on June 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.