Regeneration Nation LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

REGENERATION NATION LLC

Practice address

6565 S Yale Ave Ste 106
Tulsa, OK 74136-8302

Phone

(918) 481-2772

NPI assigned

Dec 20, 2019

Organization subpart

No

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

Authorized official

Name

Brian RoadhouseNPI 1477559201

Title

Owner, Authorized Official

Phone

(918) 481-2772

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Practitioners 3

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

• Brian Roadhouse, D.C.

  • Chiropractor
  • Tulsa, OK
  • NPI 1477559201

  OK

  Medicare reassignment NPD Authorized official
• Scott H Johnson, M.D.

  • Anesthesiology Physician
  • Oklahoma City, OK
  • NPI 1295710846

  Anesthesiology, OK

  Medicare reassignment NPD
• Jack Brenden Stookey, FNP-C

  • Family Nurse Practitioner
  • Amarillo, TX
  • NPI 1669944666

  OK

  Medicare reassignment NPD

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

{
    "created_epoch": "1576800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1164060158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6565 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741368327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6565 S YALE AVE STE 106",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741368302",
            "telephone_number": "918-481-2772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENERATION NATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-20",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A",
        "authorized_official_last_name": "ROADHOUSE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER, AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "918-481-2772"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Renee Reeves
• Taylor Reeves
• Regal Dorn Neuromonitoring LLC
• Lisa Sappington Regal, D.O.
• Reese Regan
• Regeneration Nation Tulsa LLC
• Kimberly Kaye Regenhard, APRN-CNP
• Kelsey Nicole Reger, APRN
• Regina M Mellen PLLC
• Region Dental, LLC

• All providers in Tulsa, OK
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.