GRAND TRAVERSE CHILDREN'S CLINIC (NPI# 1750398871) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750398871 |
| Entity Type | Organization |
| Organization Name | GRAND TRAVERSE CHILDREN'S CLINIC |
| Other Organization Name | GRAND TRAVERSE CHILDREN'S CLINIC |
| Practice Address |
3537 W Front St Ste G Traverse City MI 49684-7943 |
| Practice Telephone | 2319358827 |
| Mailing Telephone | 2319358827 |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. LEEANN B SPRUNK (OFFICE MANAGER) |
| Authorized Official Telephone | 2319358822 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | ========= | MI | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| GRAND TRAVERSE CHILDREN'S CLINIC | Doing Business As Name - Organization |
| Street Address |
3537 W FRONT ST STE G |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49684-7943 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851379770 | Kimberly A Hegewald | Pediatrics | 3537 W Front St Ste G, Traverse City, MI 49684-7943 | 2006-01-03 |
| 1548575764 | Tuan Bui | Pediatrics | 3537 W Front St Ste G, Traverse City, MI 49684-7943 | 2010-08-12 |
| 1932362670 | Katherine Renee Elms | Pediatrics | 3537 W Front St Ste G, Traverse City, MI 49684-7943 | 2008-07-02 |
| 1053339531 | Lisa Chimner | Pediatrics | 3537 W Front St Ste G, Traverse City, MI 49684-7943 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124641758 | Karen Anne Paulosky | Registered Nurse | 226 S Madison St, Traverse City, MI 49684 | 2020-05-18 |
| 1891314795 | Jaclyn Elizabeth Sylvain | Student in an Organized Health Care Education/Training Program | Munson Family Practice Center, 1400 Medical Campus Drive, Traverse City, MI 49684 | 2020-04-10 |
| 1285282988 | Madelyn Drumm | Dietitian, Registered | 217 S. Madison St., Suite 3022, Traverse City, MI 49684 | 2019-08-27 |
| 1265917686 | Kacie Danielle Heading | Social Worker | 12719 S. West Bay Shore Drive, Suite 9, Traverse City, MI 49684 | 2018-10-02 |
| 1881178325 | Jacob White Ph.d., Pllc | Psychologist | 3537 W. Front Street, Suite F, Traverse City, MI 49684 | 2018-09-20 |
| 1144702572 | Constance Baab, Phd, Lmsw, Pllc | Social Worker | 3301 Veterans Drive Suite 127, Traverse City, MI 49684 | 2018-09-01 |
| 1346732880 | The Skin Cancer and Dermatology Center Plc | Dermatology | 1225 W Front St Ste 2, Traverse City, MI 49684 | 2018-05-31 |
| 1790283851 | Lisa Louise Kleyps | Massage Therapist | 3337 W. South Airport Road #2, Traverse City, MI 49684 | 2018-01-24 |
| 1114447646 | Brittany Alexandra Prior | Physical Therapist | 3899 W Front Sreet, Unit 3, Traverse City, MI 49684 | 2017-06-26 |
| 1568902963 | Jennifer Scott | Behavior Technician | 515 W 14th St Unit D, Traverse City, MI 49684 | 2017-03-03 |
| Find all providers in zip 49684 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376854653 | Matthew Glenn Arnold | Pediatrics | 1105 6th St Ste 342, Traverse City, MI 49684-2345 | 2010-07-01 |
| 1346485505 | Ann Timmermann Smith | Pediatrics | 7835 Truesdale Lane, Traverse City, MI 49686-1667 | 2008-12-02 |
| 1689885824 | Sarah Christine Mulder | Pediatrics | 4020 W. Royal Drive, Traverse City, MI 49684-7548 | 2007-05-26 |
| 1851379770 | Kimberly A Hegewald | Pediatrics | 3537 W Front St Ste G, Traverse City, MI 49684-7943 | 2006-01-03 |
| 1457357832 | James Wallace Robertson | Pediatrics | 5024 N Royal Dr, Traverse City, MI 49684-9230 | 2005-06-22 |
| 1700291515 | Alyssa M Vermeulen | Pediatrics | 1105 Sixth St, Traverse City, MI 49684-2345 | 2014-07-01 |
| 1568704922 | Megan Leah Stilwill | Pediatrics | 4020 W Royal Dr, Traverse City, MI 49684-8965 | 2013-03-25 |
| 1992081640 | Regents of The University of Michigan | Pediatrics | 1200 Sixth St, Suite 100, Traverse City, MI 49684-2369 | 2011-10-26 |
| 1821380031 | Traverse Area Pediatric and Adolescent Clinic Plc | Pediatrics | 4020 W Royal Dr, Traverse City, MI 49684-8965 | 2011-05-05 |
| 1548575764 | Tuan Bui | Pediatrics | 3537 W Front St Ste G, Traverse City, MI 49684-7943 | 2010-08-12 |
| Find all providers in TRAVERSE CITY | ||||
| City | TRAVERSE CITY |
| Zip Code | 49684 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.