OrganizationActive
Crystal Lake Clinic, PC
NPI 1306190475 · Family Medicine Physician · Manton, MI
Crystal Lake Clinic, PC is a Family Medicine Physician organization in Manton, MI (NPI 1306190475).
Provider details
- NPI number
- 1306190475
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Richard Nielsen, President(231) 882-9661
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(79/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
115 E 7th St
Manton, MI 49663-9429
Phone: (231) 824-4100
Fax: (231) 824-4108
Street-level locationGet directions
Mailing address
6227 Frankfort Hwy
Benzonia, MI 49616-8632
Registry dates
- Enumerated
- 2012-10-29
- Last updated
- 2012-10-29
Frequently asked questions
- What is Crystal Lake Clinic, PC's NPI number?
- Crystal Lake Clinic, PC's National Provider Identifier (NPI) is 1306190475, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Crystal Lake Clinic, PC?
- Crystal Lake Clinic, PC is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Crystal Lake Clinic, PC located?
- Crystal Lake Clinic, PC's practice location on file with NPPES is 115 E 7th St, Manton, MI 49663-9429.
- What is Crystal Lake Clinic, PC's phone number?
- The practice phone number listed in the NPPES registry for Crystal Lake Clinic, PC is (231) 824-4100.
- Who is the authorized official for Crystal Lake Clinic, PC?
- The authorized official listed on Crystal Lake Clinic, PC's NPPES record is Richard Nielsen, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Crystal Lake Clinic, PC's NPI active?
- Yes — Crystal Lake Clinic, PC's NPI (1306190475) is active in the NPPES registry as of the last update on 2012-10-29.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.