Individual provider Active NPI

Christopher Lee Petoskey, CRNP

  • Nurse Practitioner
  • Big Rapids, MI
National Provider Identifier
1811727548
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704420004 Issued in MI
Practice address
20095 Gilbert Rd
Big Rapids, MI 49307-2365
Phone
(231) 592-1360
Fax
(231) 592-1361
NPI assigned
Aug 6, 2024
Last updated
Dec 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704420004 MI Primary
Family Nurse Practitioner 363LF0000X 4704420004 MI
Family Nurse Practitioner 363LF0000X SP030312 PA

Addresses

Primary practice location

20095 Gilbert Rd
Big Rapids, MI 49307-2365

Mailing address

20095 Gilbert Rd
Big Rapids, MI 49307-2365
Phone (231) 592-1360

Other practice location 1

1714 Pine St Apt 1F
Philadelphia, PA 19103-6776
Phone (607) 621-8459

Other practice location 2

625 W 5th St
Clare, MI 48617-9481
Phone (607) 621-8459

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
I20241211003315 MI Practitioner - Nurse Practitioner 0244770188 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Michigan Primary Care Partners P CGroup PAC ID 8527044551, 21 clinicians

Practice addresses (Care Compare)

20095 Gilbert Rd
Suite B
Big Rapids, MI 49307-2366
Phone (231) 592-1360

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704420004MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vascular Health Clinics PLLC CurrentSince Sep 27, 2024 Accepting new patients
Michigan Primary Care Partners P C CurrentSince Jan 2, 2025 Accepting new patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Jan 13, 2026 Accepting new patients

Locations

20095 Gilbert Rd
Big Rapids, MI 49307
Phone (231) 305-4095

20095 Gilbert Rd
Ste B
Big Rapids, MI 49307
Phone (231) 408-3208

10785 S Grant Ave
Clare, MI 48617
Phone (989) 254-6427

2125 Ridgewood Dr
Midland, MI 48642
Phone (989) 254-6427

8540 105th Ave
Stanwood, MI 49346
Phone (231) 972-2710

13 N Washington St
Ypsilanti, MI 48197
Phone (734) 355-4719

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17442/brand/2/csg/1/fhir/r4

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1722902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1811727548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20095 GILBERT RD",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493072365",
            "telephone_number": "231-592-1360",
            "fax_number": "231-592-1361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20095 GILBERT RD",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493072365",
            "telephone_number": "231-592-1360",
            "fax_number": "231-592-1361"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1714 Pine St Apt 1F",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191036776",
            "country_code": "US",
            "telephone_number": "607-621-8459",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "625 W 5th St",
            "address_purpose": "LOCATION",
            "city": "Clare",
            "state": "MI",
            "postal_code": "486179481",
            "country_code": "US",
            "telephone_number": "607-621-8459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETOSKEY",
        "first_name": "CHRISTOPHER",
        "middle_name": "LEE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-06",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704420004",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704420004",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP030312",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Big Rapids, MI

Sources for this page

Verify at the official NPI Registry.