Celly Health Medical Group of Northern Michigan PC
Organization Active NPI Internal Medicine Physician · Traverse City, MI
NPI 1194501130 · NPPES record last updated Oct 24, 2025
Key facts
- NPI
- 1194501130
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- CELLY HEALTH MEDICAL GROUP OF NORTHERN MICHIGAN PC
- Practice address
- 10850 E Traverse Hwy Ste 1155
Traverse City, MI 49684-1363 - Phone
- (231) 268-0013
- NPI assigned
- Sep 6, 2023
- Organization subpart
- No
Authorized official
- Name
- Shawn M Cole, MD
- Title
- President
- Phone
- (231) 933-4549
Practitioners 5
-
Shawn M Cole, MD
-
Cassidy Lynn Warner, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250416000474 | MI | Part B Supplier - Clinic/Group Practice | 9133644800 |
Receives reassigned benefits from 5 practitioners Practice locations: Traverse City, MI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | Yes |
Addresses
Primary practice location
10850 E Traverse Hwy Ste 1155
Traverse City, MI 49684-1363
Mailing address
10850 E Traverse Hwy Ste 1155
Traverse City, MI 49684-1363
Phone (231) 268-0013
Other providers in Traverse City, MI
- Cedar Run Eye Center
- Cedar Run Eye Center Optical
- Cedar Run Eye Center-Beulah Optical
- Cedar Run Eye Center, PLLC
- Rowan Celestino
- Celly Mobile Dialysis, P.a.
- Aimee Angela Cemazar
- Robert Earl Cenci
- Center for Health PLLC
- CFCC Specialty Pharmacy LLC
All providers in Traverse City, MI · Internal Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.