Organization Active NPI

John-Angella-Regina Primary Care and Wellness

  • Registered Nurse
  • Novi, MI
National Provider Identifier
1659129161
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
Legal business name
JOHN-ANGELLA-REGINA PRIMARY CARE AND WELLNESS
Practice address
27645 Albert St
Novi, MI 48374-1012
Phone
(313) 310-6761
NPI assigned
May 9, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Authorized official

Name
John Westley Mailey, NPNPI 1356953756
Title
Owner
Phone
(313) 310-6761

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
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X Primary

Addresses

Primary practice location

27645 Albert St
Novi, MI 48374-1012

Mailing address

27645 Albert St
Novi, MI 48374-1012

Other names 1

  • JAR Primary Care and Wellness Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240809000673 MI Part B Supplier - Clinic/Group Practice 6103363080 Receives reassigned benefits from 1 practitioner
Practice locations: Novi, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1715212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715212800000",
    "number": "1659129161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27645 ALBERT ST",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483741012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27645 ALBERT ST",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483741012",
            "telephone_number": "313-310-6761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN-ANGELLA-REGINA PRIMARY CARE AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-09",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A",
        "authorized_official_last_name": "MAILEY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "WESTLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-310-6761",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JAR Primary Care and Wellness",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 May 9, 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.