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LITTLE TRAVERSE BAY BANDS OF ODAWA INDIANS
NPI 1871272583
Clinic/Center - Federally Qualified Health Center (FQHC) in Petoskey, MI

Active since July 12, 2023
2390 MITCHELL PARK DR STE D, PETOSKEY, MI 49770(231) 242-1760 Get Directions Write a Review

NPPES record last updated: May 20, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 20, 2025, Jul 19, 2023, Jul 12, 2023 (3 updates tracked since 2023).

About Little Traverse Bay Bands Of Odawa Indians NPPES

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

LITTLE TRAVERSE BAY BANDS OF ODAWA INDIANS (NPI 1871272583) is a healthcare organization registered as a federally qualified health center (fqhc) in Petoskey, Michigan and active in the NPI registry since July 2023. The organization lists Christina Dubois, Assistant Health Director, as its authorized official.

NPPES Registry Identity

NPI1871272583
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameLITTLE TRAVERSE BAY BANDS OF ODAWA INDIANS
Location Address2390 MITCHELL PARK DR STE DPetoskey, MI 49770-8965
Mailing Address1260 Ajijaak AvePetoskey, MI 49770-8330 · (231) 878-0419
Phone(231) 242-1760
Organization SubpartNo
Authorized OfficialChristina DuboisAssistant Health Director · (231) 242-1611
Enumeration DateJuly 12, 2023
Last NPPES UpdateMay 20, 20253 updates tracked since enumeration
NPPES CertifiedMay 20, 2025
✔ NPI 1871272583 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
2390 MITCHELL PARK DR STE D, Petoskey, MI 49770
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Other Names 1

Other NameCrooked Tree Wellness Clinic

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.

CAROLYN MARIE WIESE PA
Physician Assistant
2390 MITCHELL PARK DR STE D
PETOSKEY, MI 49770
Emmet County (231) 487-7200
DANIEL VERBURG MD PLC
Obstetrics & Gynecology (Gynecology)
2390 MITCHELL PARK DR STE D
PETOSKEY, MI 49770
Emmet County (231) 487-9355
LANCE EDGERTON FNP-C
Nurse Practitioner (Family)
2390 MITCHELL PARK DR STE D
PETOSKEY, MI 49770
Emmet County (231) 487-7200
LITTLE TRAVERSE BAY BANDS OF ODAWA INDIANS
Pharmacy (Community/Retail Pharmacy)
2390 MITCHELL PARK DR STE D
PETOSKEY, MI 49770
Emmet County (231) 242-1760

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 Little Traverse Bay Bands Of Odawa Indians's NPI number?

The NPI number for Little Traverse Bay Bands Of Odawa Indians is 1871272583. It was assigned to this organization in the NPPES registry on July 12, 2023. The provider is also known as Crooked Tree Wellness Clinic.

Where is Little Traverse Bay Bands Of Odawa Indians located?

Little Traverse Bay Bands Of Odawa Indians is located at 2390 Mitchell Park Dr Ste D, Petoskey, MI 49770. The listed phone number is (231) 242-1760.

What is Little Traverse Bay Bands Of Odawa Indians's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

When was this NPI record last updated?

The NPPES record for Little Traverse Bay Bands Of Odawa Indians was last updated on May 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.