Regenesis Wellness LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

REGENESIS WELLNESS LLC

Practice address

2310 Vickers Dr
Colorado Springs, CO 80918-1981

Phone

(719) 428-5310

Fax

(720) 504-0186

NPI assigned

Nov 10, 2015

Organization subpart

No

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

Authorized official

Name

Anna Maria Douglas, FNP

Title

Owner

Phone

(719) 428-5310

Specialties & licenses 2

Addresses

Other names 1

• Regenesis Wellness Center Doing business as

Locations

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

{
    "created_epoch": "1447113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524009600000",
    "number": "1144693292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 VICKERS DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809181981",
            "telephone_number": "719-428-5310",
            "fax_number": "720-504-0186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 VICKERS DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809181981",
            "telephone_number": "719-428-5310",
            "fax_number": "720-504-0186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENESIS WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-10",
        "last_updated": "2018-04-18",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "ANNA MARIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-428-5310",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "0990332-NP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regenesis Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andrew Regalmuto
• Shawn Michael Regan, DPT
• Nils Rege, O.D.
• Emmi Regenbogen, STUDENT
• Regenerative Health and Wellness, Inc.
• Regents of the University of Colorado
• Regents of the University of Colorado
• Regents of the University of Colorado
• Regents of the University of Colorado
• Ivy Marie Silvestre Regidor

• Primary Care Clinic/Center in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Primary Care Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.