Creekside Internal Medicine

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CREEKSIDE INTERNAL MEDICINE

Practice address

1 William Carls Dr
Commerce TWP, MI 48382-2201

Phone

(248) 937-3300

NPI assigned

Aug 26, 2020

Last updated

Aug 26, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kathrina P Spyridakis, DONPI 1396872628

Title

President/Owner

Phone

(586) 350-6073

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kathrina Spyridakis, DO

  • Internal Medicine Physician
  • Commerce Township, MI
  • NPI 1396872628
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1598400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598400000000",
    "number": "1295348589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6035 ELDRIDGE DR",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483272631",
            "telephone_number": "586-350-6073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WILLIAM CARLS DR",
            "city": "COMMERCE TWP",
            "state": "MI",
            "postal_code": "483822201",
            "telephone_number": "248-937-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEKSIDE INTERNAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-26",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A",
        "authorized_official_last_name": "SPYRIDAKIS",
        "authorized_official_first_name": "KATHRINA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "586-350-6073",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Commerce Internal Medicine, P.C.
• Commerce Urgent Care Walk-in Clinic
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• Tacoma Marie Corbin, RN
• Kayla Cozart, OTR/L
• Owen Culpepper
• Current Health Solutions, PLLC (Active Life Chiropractic)
• Kristin Daley
• Mohammad Darwish
• Keumae Dato, CRNA

• Internal Medicine Physician in Commerce TWP, MI
• Providers in Commerce TWP, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.