Regenerative Foot & Ankle LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

REGENERATIVE FOOT & ANKLE LLC

Practice address

13660 N 94TH Dr Ste F1
Peoria, AZ 85381-4232

Phone

(623) 974-0522

NPI assigned

Feb 22, 2018

Organization subpart

No

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

Authorized official

Name

Steven Shane Moore

Title

Manager

Phone

(623) 974-0522

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1519257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581292800000",
    "number": "1154822369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13660 N 94TH DR STE F1",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13660 N 94TH DR STE F1",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814232",
            "telephone_number": "623-974-0522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENERATIVE FOOT & ANKLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-22",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "SHANE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "623-974-0522"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Reed, MSN, FNP-C
• Danielle A Reed, LCSW
• Mackenzi Reeg
• Hewitt William Reese, DPM
• Katherine Reeves, PHARMD
• Regenesis Healthcare, Inc
• Shirli Regev, PHD
• Rehabilitation Specialists Group, Inc.
• Leslie Joan Reimann, OTR/L
• Kristen Elizabeth Reiter, FNP

• Ambulatory Surgical Clinic/Center in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Ambulatory Surgical Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; 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.