Creekside Clinic, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CREEKSIDE CLINIC, LLC

Practice address

1225 W Front St
Traverse City, MI 49684-2317

Phone

(231) 935-0788

Fax

(231) 935-0787

NPI assigned

Jul 1, 2006

Last updated

Dec 8, 2012By 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

Douglas Spence Jr., MDNPI 1790875649

Title

Owner/Physician

Phone

(231) 935-0788

Specialties & licenses 3

Addresses

Locations

Practitioners 2

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.

• Douglas M Spence Jr., MD

  • Family Medicine Physician
  • Traverse City, MI
  • NPI 1790875649
  Authorized official Same address or phone
• Dona Dunkin-Alba, DO

  • Family Medicine Physician
  • Logan, OH
  • NPI 1164458295
  NPD (past)

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354924800000",
    "number": "1558390799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 W FRONT ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842317",
            "telephone_number": "231-935-0788",
            "fax_number": "231-935-0787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 W FRONT ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842317",
            "telephone_number": "231-935-0788",
            "fax_number": "231-935-0787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEKSIDE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2012-12-08",
        "status": "A",
        "authorized_official_last_name": "SPENCE",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "231-935-0788",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Craig Kuesel DO PLLC
• Judi Crane
• Mark Crane
• Crane's Nest Therapy
• Stacy Nicole Crawford, RN
• Trevor Cressman, LLMSW
• Natalie C Crew, RD
• Mindy Ann Crick, BS
• Christtraude Croissant
• Savannah Sierra Cronce

• Family Medicine Physician in Traverse City, MI
• Providers in Traverse City, 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 Dec 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.