Individual provider Active NPI

David William Peter Stalker, MD

  • Family Medicine Physician
  • Traverse City, MI
National Provider Identifier
1811699366
Registry record updated Jun 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4351050789 Issued in MI
Practice address
4025 Chums Village Dr
Traverse City, MI 49685-6992
Phone
(231) 642-5560
Fax
(231) 642-5563
NPI assigned
Mar 20, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4351050789 MI Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

4025 Chums Village Dr
Traverse City, MI 49685-6992

Mailing address

1400 Medical Campus Dr
Traverse City, MI 49684-7823
Phone (231) 935-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crystal Lake Clinic PCGroup PAC ID 0648259010, 14 clinicians

Practice addresses (Care Compare)

4025 Chums Village Dr
Traverse City, MI 49685-6992
Phone (231) 642-5560

Hospital & facility affiliations

  • Munson Medical Center Hospital, Traverse City, MI, CCN 230097

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4351050789MIMDFamily Medicine Physician

Organizations & group practices 1

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": "1679270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1811699366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 MEDICAL CAMPUS DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847823",
            "telephone_number": "231-935-8000",
            "fax_number": "231-935-8099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4025 CHUMS VILLAGE DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496856992",
            "telephone_number": "231-642-5560",
            "fax_number": "231-642-5563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALKER",
        "first_name": "DAVID",
        "middle_name": "WILLIAM PETER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-20",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4351050789",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.