Regenerative Wellness Center, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2009009432 Issued in MO

Legal business name

REGENERATIVE WELLNESS CENTER, LLC

Practice address

8633 Mexico Rd
O Fallon, MO 63366-7506

Phone

(636) 272-8888

Fax

(636) 272-7385

NPI assigned

Nov 24, 2015

Last updated

Nov 24, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael Williams

Title

Authorized Official

Phone

(636) 272-8891

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1448323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448323200000",
    "number": "1144694480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8633 MEXICO RD",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633667506",
            "telephone_number": "636-272-8888",
            "fax_number": "636-272-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8633 MEXICO RD",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633667506",
            "telephone_number": "636-272-8888",
            "fax_number": "636-272-7385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENERATIVE WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-24",
        "last_updated": "2015-11-24",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "636-272-8891"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2009009432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Amanda L Reed
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• Family Medicine Physician in O'Fallon, MO
• Providers in O'Fallon, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2015; 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.