Individual provider Active NPI

Tobin J Klint, NP

  • Nurse Practitioner
  • Stevensville, MI
National Provider Identifier
1407260201
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704286176 Issued in MI
Practice address
5515 Cleveland Ave Ste 5
Stevensville, MI 49127-9670
Phone
(269) 429-9677
NPI assigned
Jun 19, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704286176 MI Primary

Addresses

Primary practice location

5515 Cleveland Ave Ste 5
Stevensville, MI 49127-9670

Mailing address

5515 Cleveland Ave Ste 5
Stevensville, MI 49127-9670

Other practice location 1

9625 Red Arrow Hwy
Bridgman, MI 49106-9559
Phone (269) 465-6050

Other identifiers 1

IdentifierTypeStateIssuer
1407260201MedicaidMI

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
I20140820002683 MI Practitioner - Nurse Practitioner 7416175294 Reassigns benefits to 3 organizations

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
Lakeland Medical PracticesGroup PAC ID 1658427042, 286 clinicians

Practice addresses (Care Compare)

5515 Cleveland Ave
Suite 5
Stevensville, MI 49127-9670
Phone (269) 429-9644

Hospital & facility affiliations

  • Lakeland Hospital, St Joseph Hospital, St Joseph, MI, CCN 230021

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Medical Practices CurrentSince Aug 4, 2014 Accepting new patients
Lakeland Community Hospital Watervliet Current Accepting new patients
Lakeland Community Hospital Watervliet CurrentSince Dec 14, 2022 Accepting new patients
Lakeland Community Hospital Watervliet CurrentSince Oct 14, 2022 Accepting new patients
Lakeland Medical Practices CurrentSince Aug 4, 2014 Accepting new patients
Lakeland Community Hospital Watervliet CurrentSince Oct 14, 2022 Accepting new patients
Lakeland Community Hospital Watervliet Past Accepting new patients

Locations

9625 Red Arrow Hwy
Bridgman, MI 49106
Phone (269) 465-6050

2002 S 11th St
Niles, MI 49120
Phone (269) 687-0200

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

5515 Cleveland Ave
Ste 5
Stevensville, MI 49127
Phone (269) 429-9644

460 Medical Park Dr
Ste 200
Watervliet, MI 49098

400 Medical Park Dr
Watervliet, MI 49098
Phone (269) 463-3111

Interoperability endpoints

  • Direct secure messaging: tklint7166@lakeland.midirect.net
  • FHIR API: https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/
  • Direct secure messaging: tklint1270328@epic00.corewelldirect.org

Organizations & group practices 7

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 1

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": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1407260201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5515 CLEVELAND AVE STE 5",
            "city": "STEVENSVILLE",
            "state": "MI",
            "postal_code": "491279670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5515 CLEVELAND AVE STE 5",
            "city": "STEVENSVILLE",
            "state": "MI",
            "postal_code": "491279670",
            "telephone_number": "269-429-9677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9625 Red Arrow Hwy",
            "address_purpose": "LOCATION",
            "city": "Bridgman",
            "state": "MI",
            "postal_code": "491069559",
            "country_code": "US",
            "telephone_number": "269-465-6050",
            "fax_number": "269-465-3134",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLINT",
        "first_name": "TOBIN",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-19",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704286176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407260201",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stevensville, MI

Sources for this page

Verify at the official NPI Registry.