Rejuvenated Health & Wellness

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

REJUVENATED HEALTH & WELLNESS

Doing business as

Rejuvenated Health & Wellness

Practice address

5221 S Highway 95 Ste 13
Fort Mohave, AZ 86426-9244

Phone

(928) 234-7572

NPI assigned

Jan 2, 2021

Last updated

Jul 6, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

NIPPIESAs reported in NPPES

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

Authorized official

Name

Dayna BlakeNPI 1548825789

Title

FNP-BC

Phone

(928) 201-8289

Specialties & licenses 1

Addresses

Other names 1

• Rejuvenated Health & Wellness Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Rejuvenated Health Wellness

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dayna Blake, FNP- BC

  • Primary Care Nurse Practitioner
  • Fort Mohave, AZ
  • NPI 1548825789
  NPD Authorized official

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

{
    "created_epoch": "1609545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657065600000",
    "number": "1063000479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10837",
            "city": "FORT MOHAVE",
            "state": "AZ",
            "postal_code": "864270837",
            "telephone_number": "928-201-8289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5221 S HIGHWAY 95 STE 13",
            "city": "FORT MOHAVE",
            "state": "AZ",
            "postal_code": "864269244",
            "telephone_number": "928-234-7572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REJUVENATED HEALTH & WELLNESS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NIPPIES",
        "enumeration_date": "2021-01-02",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A",
        "authorized_official_last_name": "BLAKE",
        "authorized_official_first_name": "DAYNA",
        "authorized_official_title_or_position": "FNP-BC",
        "authorized_official_telephone_number": "928-201-8289"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rejuvenated Health & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Nurse Practitioner in Fort Mohave, AZ
• Providers in Fort Mohave, AZ by specialty
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.