Organization Active NPI

Staywell Spine and Joint Specialists LLC

  • Chiropractor
  • Novi, MI
National Provider Identifier
1386032357
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
STAYWELL SPINE AND JOINT SPECIALISTS LLC
Practice address
26200 Town Center Dr Ste 165
Novi, MI 48375-1219
Phone
(248) 513-3100
Fax
(248) 679-3061
NPI assigned
Dec 29, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Authorized official

Name
Dr. Amy Olson, D.C.
Title
Owner
Phone
(248) 513-3100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

26200 Town Center Dr Ste 165
Novi, MI 48375-1219

Mailing address

26200 Town Center Dr Ste 165
Novi, MI 48375-1219
Phone (248) 513-3100

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL ChiroTouch Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150128001761 MI Part B Supplier - Clinic/Group Practice 3577887215 Receives reassigned benefits from 4 practitioners
Practice locations: Novi, MI
O20240731000753 MI DME Supplier - Nurse Practitioner 3577887215 Practice locations: Novi, MI

National Provider Directory

National Provider Directory

Locations

42040 Grand River Ave
Novi, MI 48375
Phone (248) 344-1616

Practitioners & affiliated clinicians

Practitioners 6

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": "1419811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692662400000",
    "number": "1386032357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26200 TOWN CENTER DR STE 165",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751219",
            "telephone_number": "248-513-3100",
            "fax_number": "248-679-3061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26200 TOWN CENTER DR STE 165",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751219",
            "telephone_number": "248-513-3100",
            "fax_number": "248-679-3061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAYWELL SPINE AND JOINT SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-29",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-513-3100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "ChiroTouch",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "26200 Town Center Dr Ste 165",
            "city": "Novi",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483751219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; 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.