| Grand Traverse Band Of Ottawa And Chippewa Indians | |
|
2300 N Stallman Rd Ste A Suttons Bay MI 49682-9158 | |
| (231) 534-7200 | |
| (231) 534-7460 |
| Full Name | Grand Traverse Band Of Ottawa And Chippewa Indians |
|---|---|
| Speciality | Clinic/Center |
| Location | 2300 N Stallman Rd Ste A, Suttons Bay, Michigan |
| Authorized Official Name and Position | Sonya Zotigh (HEALTH ADMIN) |
| Authorized Official Contact | 2315347241 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grand Traverse Band Of Ottawa And Chippewa Indians 2300 N Stallman Rd Ste A Suttons Bay MI 49682-9158 Ph: (231) 534-7200 | Grand Traverse Band Of Ottawa And Chippewa Indians 2300 N Stallman Rd Ste A Suttons Bay MI 49682-9158 Ph: (231) 534-7200 |
| NPI Number | 1134281132 |
|---|---|
| Provider Enumeration Date | 12/15/2006 |
| Last Update Date | 02/11/2025 |
| Medicare PECOS PAC ID | 5193792067 |
|---|---|
| Medicare Enrollment ID | O20040911000198 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134281132 | NPI | - | NPPES |
| 1376553586 | Medicaid | MI | |
| 700D545020 | Other | MI | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Cheryl S Loubert |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376553586 PECOS PAC ID: 7315917572 Enrollment ID: I20040727000821 |
| Provider Name | Peter Benson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255499281 PECOS PAC ID: 7416842802 Enrollment ID: I20070926000706 |
| Provider Name | Samantha J Haken |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154735850 PECOS PAC ID: 3870710585 Enrollment ID: I20140804000982 |
| Provider Name | Kimberly Oldenburg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659977510 PECOS PAC ID: 4082093109 Enrollment ID: I20220621001934 |
| Provider Name | Sandra Handysides |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003197583 PECOS PAC ID: 2264811397 Enrollment ID: I20220621002366 |
| Provider Name | Emily Marie Schmitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114573284 PECOS PAC ID: 3678805496 Enrollment ID: I20220622000409 |
| Provider Name | Angela Kay Schaub |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760174981 PECOS PAC ID: 0648706069 Enrollment ID: I20241209003888 |
Crystal Lake Clinic P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 650 S West Bay Shore Dr, Suttons Bay, MI 49682 Phone: 231-882-9661 | |
Leelanau Family Practice Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 718 N Saint Joseph St Unit K1, Suttons Bay, MI 49682 Phone: 231-386-0088 | |
Mark A Priest Do Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 650 S West Bay Shore Dr, Suttons Bay, MI 49682 Phone: 231-271-5161 Fax: 231-271-3590 | |
Suttons Bay Medical Clinic, Plc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 93b Fourth St, Suttons Bay, MI 49682 Phone: 231-271-5990 Fax: 231-271-5959 | |
Leelanau Urgent Care, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 650 S West Bay Shore Dr, Suttons Bay, MI 49682 Phone: 231-271-6511 Fax: 231-271-6519 | |
Geriatric Physician Staffing Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 124 W Fourth St, Suttons Bay, MI 49682 Phone: 231-271-1200 Fax: 231-271-5959 |