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CRYSTAL LAKE CLINIC, P.C.
NPI 1902851777
Family Medicine in Bear Lake, MI

Active since May 23, 2006CLIA 23D0892491 · Waiver
8225 LAKE ST, BEAR LAKE, MI 49614(231) 864-3314 Get Directions Write a Review

NPPES record last updated: November 6, 2018. Verified against the NPPES registry weekly; last sync: August 02, 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 1902851777) is a healthcare organization registered as a family medicine in Bear Lake, Michigan and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through September 29, 2026 and lists Richard C Nielsen, President, as its authorized official.

NPPES Registry Identity

NPI1902851777
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameCRYSTAL LAKE CLINIC, P.C.
Location Address8225 LAKE STBear Lake, MI 49614-9688
Mailing Address6227 Frankfort HwyBenzonia, MI 49616-9654 · (231) 882-9661 · Fax (231) 882-9616
Phone(231) 864-3314
Organization SubpartNo
Authorized OfficialRichard C NielsenPresident · (231) 882-9661
Enumeration DateMay 23, 2006
Last NPPES UpdateNovember 6, 2018
✔ NPI 1902851777 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.
8225 LAKE ST, Bear Lake, MI 49614
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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 Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company.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 of Waiver 23D0892491

Crystal Lake Clinic P C - Bear Lake · Bear Lake, MI
Active · expires Sep 29, 2026
CLIA Number23D0892491
Laboratory TypePhysician Office
Certificate Effective DateSeptember 30, 2024
Certificate Expiration DateSeptember 29, 2026
Laboratory DirectorJacob G. Flynn
Laboratory Phone(616) 864-3314
Laboratory LocationCrystal Lake Clinic P C - Bear Lake8225 Lake Street, Bear Lake, MI 49614
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 9

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

ELLEN MARIE HERRING FNP
Nurse Practitioner (Family)
8225 LAKE ST
BEAR LAKE, MI 49614
Manistee County (231) 864-3314
AUDREY MATTINGLY
Behavior Technician
8225 LAKE ST
BEAR LAKE, MI 49614
Manistee County (231) 655-3146
JACQUELINE J NORTON PA-C
Physician Assistant
8225 LAKE ST
BEAR LAKE, MI 49614
Manistee County (231) 864-3314
CHANDLER FELTY
Behavior Technician
8225 LAKE ST
BEAR LAKE, MI 49614
Manistee County (231) 655-3146
MARYANN MARIE SMITH
Physician Assistant
8225 LAKE ST
BEAR LAKE, MI 49614
Manistee County (231) 864-3314
EMMA QUICK
Behavior Technician
8225 LAKE ST
BEAR LAKE, MI 49614
Manistee County (231) 655-3146
GLENN CHARLES GRIFFITHS M.D.
Family Medicine
8225 LAKE ST
BEAR LAKE, MI 49614
Manistee County (231) 864-3314
SARAH NICHOLS
Behavior Technician
8225 LAKE ST
BEAR LAKE, MI 49614
Manistee County (231) 655-3146

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 1902851777. It was assigned to this organization in the NPPES registry on May 23, 2006.

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

Crystal Lake Clinic, P.C. is located at 8225 Lake St, Bear Lake, MI 49614. The listed phone number is (231) 864-3314.

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

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

Does Crystal Lake Clinic, P.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D0892491) is associated with this NPI, valid through September 29, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Crystal Lake Clinic, P.C. accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Crystal Lake Clinic, P.C. 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, P.C. was last updated on November 6, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.