Individual provider Active NPI

Lindsey Banktson, PA

  • Physician Assistant
  • Benzonia, MI
National Provider Identifier
1447759097
Registry record updated Mar 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601008565 Issued in MI
Practice address
6227 Frankfort Hwy
Benzonia, MI 49616-8632
Phone
(231) 882-9661
Fax
(231) 882-9616
NPI assigned
Feb 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601008565 MI Primary

Addresses

Primary practice location

6227 Frankfort Hwy
Benzonia, MI 49616-8632

Mailing address

6227 Frankfort Hwy
Benzonia, MI 49616-8632
Phone (231) 882-9661

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
I20180309000482 MI Practitioner - Physician Assistant 9638430556 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
30 of 100Reported as group
Quality
0
Promoting interoperability
100
Improvement activities
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601008565MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Crystal Lake Clinic P.C. CurrentSince Feb 12, 2018 Accepting new patients
Crystal Lake Clinic, P.C. Past Accepting new patients
Crystal Lake Clinic P.C. Past Accepting new patients
Crystal Lake Clinic P.C. Past Accepting new patients

Locations

6227 Frankfort Hwy
Benzonia, MI 49616
Phone (231) 882-9661

124 Ames St
Elk Rapids, MI 49629
Phone (231) 264-8282

1975 Stirling Dr
Interlochen, MI 49643
Phone (231) 275-0166

2283 E M 113
Kingsley, MI 49649
Phone (231) 263-0700

2198 US Highway 31 S
Manistee, MI 49660
Phone (231) 655-3146

93 W Fourth St
Ste B
Suttons Bay, MI 49682
Phone (231) 271-5990

4025 Chums Village Dr
Traverse City, MI 49685
Phone (231) 252-3433

Interoperability endpoints

  • Direct secure messaging: lindseybanktson@clhcmi.allscriptsdirect.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1518134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520553600000",
    "number": "1447759097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6227 FRANKFORT HWY",
            "city": "BENZONIA",
            "state": "MI",
            "postal_code": "496168632",
            "telephone_number": "231-882-9661",
            "fax_number": "231-882-9616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6227 FRANKFORT HWY",
            "city": "BENZONIA",
            "state": "MI",
            "postal_code": "496168632",
            "telephone_number": "231-882-9661",
            "fax_number": "231-882-9616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANKTSON",
        "first_name": "LINDSEY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-09",
        "last_updated": "2018-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benzonia, MI

Sources for this page

Verify at the official NPI Registry.