Individual provider Active NPI

Renee Amy Fay, D.C.

  • Chiropractor
  • Allendale, MI
National Provider Identifier
1689913618
Registry record updated Oct 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301010070 Issued in MI
Practice address
5164 Lake Michigan Dr Ste D
Allendale, MI 49401-8506
Phone
(616) 777-0309
NPI assigned
Feb 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301010070 MI Primary

Addresses

Primary practice location

5164 Lake Michigan Dr Ste D
Allendale, MI 49401-8506

Mailing address

11542 Bowens Mill Rd
Middleville, MI 49333-9761
Phone (989) 415-0465

Other names 1

  • Renee Maurer Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130228000399 MI Practitioner - Chiropractic 5496900219 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6825 Hanna Lake Ave SE
Caledonia, MI 49316-9118
Phone (616) 803-0434

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301010070MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
In 8 PC Chiropractor CurrentSince Feb 12, 2013 Accepting new patients
Restoration Chiropractic, PLLC Chiropractor CurrentSince Dec 17, 2018 Accepting new patients

Locations

6825 Hanna Lake Ave SE
Caledonia, MI 49316
Phone (586) 596-2370

537 N Clippert St
Lansing, MI 48912
Phone (517) 203-2090

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1360627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539129600000",
    "number": "1689913618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11542 BOWENS MILL RD",
            "city": "MIDDLEVILLE",
            "state": "MI",
            "postal_code": "493339761",
            "telephone_number": "989-415-0465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5164 LAKE MICHIGAN DR STE D",
            "city": "ALLENDALE",
            "state": "MI",
            "postal_code": "494018506",
            "telephone_number": "616-777-0309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAY",
        "first_name": "RENEE",
        "middle_name": "AMY",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-12",
        "last_updated": "2018-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENEE",
            "last_name": "MAURER",
            "credential": "D.C.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Allendale, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.