Regenaderm LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

REGENADERM LLC

Practice address

7510 Highway 107
Sherwood, AR 72120-4645

Phone

(479) 439-9696

Fax

(479) 485-2055

NPI assigned

Aug 16, 2024

Organization subpart

No

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

Authorized official

Name

Charles Floyd

Title

Ceo

Phone

(501) 529-3953

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

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

Medicare medical equipment & supply locations

Locations

Practitioners 2

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

• Dennis Kenneth Counts, PHD

  • Psychologist
  • Sherwood, AR
  • NPI 1376501361
  NPD (past)
• Patricia A Scott, LCSW

  • Clinical Social Worker
  • Sherwood, AR
  • NPI 1932196425
  NPD (past)

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

{
    "created_epoch": "1723766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743638400000",
    "number": "1104658293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 105",
            "city": "FARMINGTON",
            "state": "AR",
            "postal_code": "727300105",
            "telephone_number": "479-439-9696",
            "fax_number": "479-485-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7510 HIGHWAY 107",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721204645",
            "telephone_number": "479-439-9696",
            "fax_number": "479-485-2055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENADERM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-16",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A",
        "authorized_official_last_name": "FLOYD",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "501-529-3953"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaylee Loraine Ray, PT
• Raymond Marecek MD PA
• Faith Evelyn Reaves
• Candace Reese
• Keairra Reese
• Joanna Bentley Reinhardt, COTA
• Retirement Centers of Arkansas
• Jami Lynn Rhoads, M.S., CCC-SLP
• Destiny L Richardson
• Elizabeth A Richardson, SLP

• Durable Medical Equipment & Medical Supplies in Sherwood, AR
• Providers in Sherwood, AR by specialty
• Durable Medical Equipment & Medical Supplies in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2025; 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.