CRYSTAL LAKE CLINIC, P.C.
NPI 1902851777
Family Medicine in Bear Lake, MI
NPI Status: Active since May 23, 2006
- Organization
- Family Medicine
- Accepts Insurance
- CLIA Number: 23D0892491
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 09-29-2026
About CRYSTAL LAKE CLINIC, P.C.
This page provides the complete NPI Profile along with additional information for Crystal Lake Clinic, P.c., a primary care provider established in Bear Lake, Michigan operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1902851777 assigned on May 2006. The practitioner's primary taxonomy code is 207Q00000X. The provider is registered as an organization and their NPI record was last updated 7 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Richard C Nielsen M.d. (President)
- NPI
- 1902851777
- Provider Name
- CRYSTAL LAKE CLINIC, P.C.
- Entity Type
- Organization
- Location Address
- 8225 LAKE ST BEAR LAKE, MI 49614
- Location Phone
- (231) 864-3314
- Mailing Address
- 6227 FRANKFORT HWY BENZONIA, MI 49616
- Mailing Phone
- (231) 882-9661
- Mailing Fax
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-23-2006
- Last Update Date
- 11-06-2018
- Code Navigator
A primary care provider (PCP) like Crystal Lake Clinic, P.c. sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- 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.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Cross� Preferred HMO Bronze Extra - HMO
- Blue Cross� Preferred HMO Bronze Saver HSA - HMO
- Blue Cross� Preferred HMO Bronze Secure - HMO
- Blue Cross� Preferred HMO Gold - HMO
- Blue Cross� Preferred HMO Gold Extra - HMO
- Blue Cross� Preferred HMO Silver - HMO
- Blue Cross� Preferred HMO Silver Extra - HMO
- Blue Cross� Preferred HMO Silver Saver - HMO
- Blue Cross� Preferred HMO Value - HMO
- Blue Cross� Select HMO Bronze Extra - HMO
- Blue Cross� Select HMO Bronze Saver HSA - HMO
- Blue Cross� Select HMO Bronze Secure - HMO
- Blue Cross� Select HMO Silver - HMO
- Blue Cross� Select HMO Silver Extra - HMO
- Blue Cross� Select HMO Silver Saver - HMO
- Blue Cross� Select HMO Value - HMO
- Blue Cross� Premier PPO Bronze Extra - PPO
- Blue Cross� Premier PPO Bronze HSA - PPO
- Blue Cross� Premier PPO Bronze Secure - PPO
- Blue Cross� Premier PPO Gold - PPO
- Blue Cross� Premier PPO Gold Extra - PPO
- Blue Cross� Premier PPO Silver - PPO
- Blue Cross� Premier PPO Silver Extra - PPO
- Blue Cross� Premier PPO Silver Saver HSA - PPO
- Blue Cross� Premier PPO Value - PPO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 8 - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 12 with First 4 Primary Care Visits Free - HMO
- Silver 8 - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 23D0892491
- Facility Type
- Physician Office
- Certificate Effective Date
- September 30, 2024
- Certificate Expiration Date
- September 29, 2026
- Laboratory Director
- JACOB G. FLYNN
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Crystal Lake Clinic, P.c. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for CRYSTAL LAKE CLINIC, P.C.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 9 | 0 | 2 | 8 | 5 | 1 | 7 | 7 | 7 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 9 | 0 | 2 | 16 | 5 | 2 | 7 | 14 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 9 + 0 + 2 + 1 + 6 + 5 + 2 + 7 + 1 + 4 + 24 = 63 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 63 = 7 | 7 | ||||||||
The NPI number 1902851777 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 6 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1316040645 | ELLEN MARIE HERRING FNP Individual | Nurse Practitioner (Family) | 8225 LAKE ST BEAR LAKE, MI 49614 (231) 864-3314 |
| 1801363494 | MARYANN MARIE SMITH Individual | Physician Assistant | 8225 LAKE ST BEAR LAKE, MI 49614 (231) 864-3314 |
| 1932199965 | GLENN CHARLES GRIFFITHS M.D. Individual | Family Medicine | 8225 LAKE ST BEAR LAKE, MI 49614 (231) 864-3314 |
| 1427156512 | JACQUELINE J NORTON PA-C Individual | Physician Assistant | 8225 LAKE ST BEAR LAKE, MI 49614 (231) 864-3314 |
| 1891505681 | EMMA QUICK Individual | Behavior Technician | 8225 LAKE ST BEAR LAKE, MI 49614 (231) 655-3146 |
| 1932992534 | SARAH NICHOLS Individual | Behavior Technician | 8225 LAKE ST BEAR LAKE, MI 49614 (231) 655-3146 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1902851777, enumerated in the NPI registry as an "organization" on May 23, 2006
The provider is located at 8225 Lake St Bear Lake, Mi 49614 and the phone number is (231) 864-3314
This medical organization specializes in Family Medicine with taxonomy code 207Q00000X
The provider might be accepting Accepts: Blue Care Network of Michigan, Blue Cross Blue. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 23D0892491 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on May 23, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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