Regenerise Health LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

REGENERISE HEALTH LLC

Practice address

300 Church St Ste 103
Yalesville, CT 06492-2253

Phone

(860) 994-7339

NPI assigned

Apr 6, 2023

Last updated

Jul 16, 2023By 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

Authurine Hannam-DavisNPI 1891241873

Title

Aprn

Phone

(860) 994-7339

Specialties & licenses 1

Addresses

Tax ID family

Regenerise Health LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Regenerise Health LLC

  • Clinic/Center
  • Wallingford, CT
  • NPI 1083317390
  NPD tax ID

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.

• Authurine Hannam-Davis, A.P.R.N

  • Family Nurse Practitioner
  • Wallingford, CT
  • NPI 1891241873
  NPD Authorized official

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

{
    "created_epoch": "1680739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689465600000",
    "number": "1154016160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CHURCH ST STE 103",
            "city": "YALESVILLE",
            "state": "CT",
            "postal_code": "064922253",
            "telephone_number": "860-994-7339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CHURCH ST STE 103",
            "city": "YALESVILLE",
            "state": "CT",
            "postal_code": "064922253",
            "telephone_number": "860-994-7339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENERISE HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-06",
        "last_updated": "2023-07-16",
        "certification_date": "2023-07-16",
        "status": "A",
        "authorized_official_last_name": "HANNAM-DAVIS",
        "authorized_official_first_name": "AUTHURINE",
        "authorized_official_title_or_position": "APRN",
        "authorized_official_telephone_number": "860-994-7339"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Marie Michaud
• Samantha Miller-Hood, LCSW
• Mary Kathryn Nicoll, LCSW
• On the Right Trackcounseling LLC
• Jessica E Ray, LPC
• Shayna Marie Shorrock, APRN
• Silvia Sandoval, LCSW
• Marla S. Slack, LPC
• Sulakshana Sundaresan, DDS
• Alexa Jane Lee Sutherland, LCSW

• Health Service Clinic/Center in Yalesville, CT
• Providers in Yalesville, CT by specialty
• Health Service Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2023; 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.