Organization Active NPI

Olcott Spine Institute Incorporated

Doing business as Olcott Chiropractic and Wellness Center

  • Chiropractor
  • Lady Lake, FL
National Provider Identifier
1003291469
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH10420 Issued in FL
Legal business name
OLCOTT SPINE INSTITUTE INCORPORATED
Doing business as
Olcott Chiropractic and Wellness Center
Practice address
113 W Lemon Street
Lady Lake, FL 32159-3855
Phone
(352) 633-1048
Fax
(352) 633-5274
NPI assigned
Jul 28, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Authorized official

Name
Dr. Joshua Olcott, D.C.NPI 1912148354
Title
Business Owner
Phone
(352) 633-1048

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH10420 FL Primary

Addresses

Primary practice location

113 W Lemon Street
Lady Lake, FL 32159-3855

Mailing address

113 W Lemon Street
Lady Lake, FL 32159
Phone (352) 633-1048

Other practice location 1

201 W Guava St
Suite 201
Lady Lake, FL 32159-1701
Phone (352) 633-1048

Other names 1

  • Olcott Chiropractic and Wellness Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150819006825 FL Part B Supplier - Clinic/Group Practice 6507171691 Receives reassigned benefits from 2 practitioners
Practice locations: Lady Lake, FL

National Provider Directory

National Provider Directory

Locations

113 W Lemon St
Lady Lake, FL 32159
Phone (352) 633-1048

201 W Guava St
Ste 201
Lady Lake, FL 32159
Phone (352) 633-1048

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1438041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712102400000",
    "number": "1003291469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 W LEMON STREET",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "32159",
            "telephone_number": "352-633-1048",
            "fax_number": "352-633-5274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 W LEMON STREET",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321593855",
            "telephone_number": "352-633-1048",
            "fax_number": "352-633-5274"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 W Guava St",
            "address_2": "Suite 201",
            "address_purpose": "LOCATION",
            "city": "Lady Lake",
            "state": "FL",
            "postal_code": "321591701",
            "country_code": "US",
            "telephone_number": "352-633-1048",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OLCOTT SPINE INSTITUTE INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-28",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-01",
        "status": "A",
        "authorized_official_last_name": "OLCOTT",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "352-633-1048",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Olcott Chiropractic and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lady Lake, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.