Spring Street Family Practice

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4704126534 Issued in MI

Legal business name

SPRING STREET FAMILY PRACTICE

Practice address

1207 N Spring St
Gladwin, MI 48624

Phone

(989) 426-5553

NPI assigned

Oct 31, 2006

Organization subpart

No

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

Authorized official

Name

Janet Flynn, NPNPI 1710063755

Title

Owner

Phone

(989) 426-5590

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Janet Flynn, NP

  • Family Nurse Practitioner
  • Gladwin, MI
  • NPI 1710063755
  Medicare reassignment Care Compare group NPD Authorized official
• Mary Theresia Bosman, APRN

  • Family Nurse Practitioner
  • Sanford, MI
  • NPI 1821457854
  Medicare reassignment Care Compare group NPD
• Tammy Marie Milbocker, NP-C

  • Nurse Practitioner
  • Saginaw, MI
  • NPI 1790209161

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Nicole Susanne Cameron, NP

  • Nurse Practitioner
  • Grayling, MI
  • NPI 1710466024
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661212800000",
    "number": "1083790026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 JOE MANN BLVD STE P-6",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486428900",
            "telephone_number": "989-791-2455",
            "fax_number": "989-791-1392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 N SPRING ST",
            "city": "GLADWIN",
            "state": "MI",
            "postal_code": "48624",
            "telephone_number": "989-426-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRING STREET FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A",
        "authorized_official_last_name": "FLYNN",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-426-5590",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4704126534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4458397",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3012794",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4640974",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lynn Skone
• Ester Jean Smith, LLBSW
• Jeanette Smith
• Lavel Irene Smith
• McKenzie Snooks
• Ashley Staley, CPR CERTIFIED
• Brooke Elizabeth-Clute Stewart
• Christina Stickler
• Jeffrey Carl Stone, DPM
• Julietta Strauer, CCAR

• Family Medicine Physician in Gladwin, MI
• Providers in Gladwin, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.