Individual provider Active NPI

Kristi Lynn Dipzinski, NP-C

  • Adult Health Nurse Practitioner
  • Petoskey, MI
National Provider Identifier
1053728840
Registry record updated Jul 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
4704212979 Issued in MI
Practice address
560 W Mitchell St
Suite 300
Petoskey, MI 49770-2275
Phone
(231) 487-2460
Fax
(231) 487-5965
NPI assigned
Jul 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 4704212979 MI Primary
Gerontology Clinical Nurse Specialist 364SG0600X 4704212979 MI

Addresses

Primary practice location

560 W Mitchell St
Suite 300
Petoskey, MI 49770-2275

Mailing address

560 W Mitchell St
Suite 300
Petoskey, MI 49770-2275
Phone (231) 487-2460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140923000072 MI Practitioner - Nurse Practitioner 4486873544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Central MichiganGroup PAC ID 6103733092, 183 clinicians

Practice addresses (Care Compare)

1221 S Dr
Mount Pleasant, MI 48858-3257
Phone (989) 772-6811

1320 E M
Suite 32
Gaylord, MI 49735-8378
Phone (989) 731-5092

560 W Mitchell St
Petoskey, MI 49770-2278

560 W Mitchell St
Suite C70
Petoskey, MI 49770-2275
Phone (231) 487-7200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704212979MIMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Central Michigan Current Accepting new patients
McLaren Central Michigan CurrentSince Sep 1, 2020 Accepting new patients
McLaren Central Michigan CurrentSince Sep 1, 2020 Accepting new patients
McLaren Central Michigan Past Accepting new patients

Locations

1221 South Dr
Mt Pleasant, MI 48858
Phone (989) 772-6700

416 Connable Ave
Petoskey, MI 49770
Phone (231) 487-4000

2390 Mitchell Park Dr
Ste D
Petoskey, MI 49770
Phone (231) 242-1760

560 W Mitchell St
Ste 300
Petoskey, MI 49770
Phone (231) 487-2460

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405296000000",
    "number": "1053728840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 W MITCHELL ST",
            "address_2": "SUITE 300",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702275",
            "telephone_number": "231-487-2460",
            "fax_number": "231-487-5965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 W MITCHELL ST",
            "address_2": "SUITE 300",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702275",
            "telephone_number": "231-487-2460",
            "fax_number": "231-487-5965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIPZINSKI",
        "first_name": "KRISTI",
        "middle_name": "LYNN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-14",
        "last_updated": "2014-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704212979",
            "primary": true
        },
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "MI",
            "license": "4704212979",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petoskey, MI

Sources for this page

Verify at the official NPI Registry.