Brookside Family Medicine a Center for Health and Well-Being PLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301068214 Issued in MI

Legal business name

BROOKSIDE FAMILY MEDICINE A CENTER FOR HEALTH AND WELL-BEING PLC

Practice address

647 E Eighth St
Traverse City, MI 49686-2630

Phone

(231) 922-0400

Fax

(855) 586-8399

NPI assigned

Dec 3, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Debra Kay Graetz, MDNPI 1104963115

Title

Owner/Physician

Phone

(231) 922-0400

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Debra Kay Graetz, MD

  • Family Medicine Physician
  • Traverse City, MI
  • NPI 1104963115
  Medicare reassignment Care Compare group NPD Authorized official
• Kathryn F Krezoski-Evans, D.O.

  • Family Medicine Physician
  • Empire, MI
  • NPI 1194136721
  Medicare reassignment Care Compare group NPD
• Jennifer Marie Perkins, D.O.

  • Family Medicine Physician
  • Traverse City, MI
  • NPI 1528283199
  Medicare reassignment Care Compare group NPD
• Christy Joy Alexander, P.A.-C

  • Medical Physician Assistant
  • Traverse City, MI
  • NPI 1508854035
  Medicare reassignment Care Compare group
• Molly Arnold Craven, D.O.

  • Family Medicine Physician
  • Mason, MI
  • NPI 1528273026
  Medicare reassignment NPD

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

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707955200000",
    "number": "1699957571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "647 E EIGHTH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496862630",
            "telephone_number": "231-922-0400",
            "fax_number": "855-586-8399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "647 E EIGHTH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496862630",
            "telephone_number": "231-922-0400",
            "fax_number": "855-586-8399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKSIDE FAMILY MEDICINE A CENTER FOR HEALTH AND WELL-BEING PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-03",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A",
        "authorized_official_last_name": "GRAETZ",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "231-922-0400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301068214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4102107",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "0280363",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI GROUP",
            "identifier": "0B810140",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Nicole Broering-Robbins, DPT, MA
• Kevin A Brokaw, PA-C
• Sarah Brokaw, PT
• Julie Brons, D.C.
• Bronson Village Drug, Inc.
• Edward J Brophy, D.O.
• Barry L Brown, RPH
• Dawn Brown, OTR/L
• Dawn Louise Brown, AGANP
• Elena Brown

• 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 Feb 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.