Crystal Lake Clinic P.C.
NPI 1417902057 · Family Medicine Physician · Interlochen, MI
Crystal Lake Clinic P.C. is a Family Medicine Physician organization in Interlochen, MI (NPI 1417902057).
Provider details
- NPI number
- 1417902057
- 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
- Pediatrics Physician208000000X
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 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
Mailing address
Registry dates
- Enumerated
- 2006-05-23
- Last updated
- 2011-02-14
Frequently asked questions
- What is Crystal Lake Clinic P.C.'s NPI number?
- Crystal Lake Clinic P.C.'s National Provider Identifier (NPI) is 1417902057, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Crystal Lake Clinic P.C.?
- Crystal Lake Clinic P.C. is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Crystal Lake Clinic P.C. located?
- Crystal Lake Clinic P.C.'s practice location on file with NPPES is 1975 Stirling Dr, Interlochen, MI 49643-9264.
- What is Crystal Lake Clinic P.C.'s phone number?
- The practice phone number listed in the NPPES registry for Crystal Lake Clinic P.C. is (231) 275-7965.
- Who is the authorized official for Crystal Lake Clinic P.C.?
- The authorized official listed on Crystal Lake Clinic P.C.'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 P.C.'s NPI active?
- Yes — Crystal Lake Clinic P.C.'s NPI (1417902057) is active in the NPPES registry as of the last update on 2011-02-14.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.