Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Crystal Lake Clinic PC

Family Medicine Physician in Manistee, MI · enumerated 2012 · authorized official Richard Nielsen, President.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1134491731

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Registry record

Entity type Organization (Type 2)

Legal business name Crystal Lake Clinic PC

Practice address 1806 E Parkdale Ave Ste 2, Manistee, MI, 49660

Phone (231) 882-9661

Enumeration date Jan 30, 2012

Last updated in NPPES Jan 30, 2012

Taxonomy & classification

207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians Primary

Authorized official

Name Richard Nielsen

Title President

Phone (231) 882-9661

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2012-01-30. Verify at npiregistry.cms.hhs.gov.

Where is Crystal Lake Clinic PC located?

The practice location on file with NPPES is in Manistee, MI.

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2012-01-30.