NPIMap

Organization Active NPI

Regenesis

  • Multi-Specialty Clinic/Center
  • Huntsville, AL
National Provider Identifier
1164976825
Registry record updated Aug 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
14864 Issued in AL
Legal business name
REGENESIS
Practice address
300 Randolph Ave SE
Huntsville, AL 35801-4118
Phone
(256) 715-8193
NPI assigned
Aug 11, 2016
Last updated
Aug 11, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2016

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

Authorized official

Name
Dr. Charles Ivy Lee, MDNPI 1255310363
Title
Physician/Owner
Phone
(256) 715-8193

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X 14864 AL Primary

Addresses

Primary practice location

300 Randolph Ave SE
Huntsville, AL 35801-4118

Mailing address

300 Randolph Ave SE
Huntsville, AL 35801-4118
Phone (256) 715-8193

National Provider Directory

National Provider Directory

Locations

300 Randolph Ave SE
Huntsville, AL 35801
Phone (256) 715-8193

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1470873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470873600000",
    "number": "1164976825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 RANDOLPH AVE SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014118",
            "telephone_number": "256-715-8193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 RANDOLPH AVE SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014118",
            "telephone_number": "256-715-8193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENESIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-11",
        "last_updated": "2016-08-11",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "IVY",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "256-715-8193",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "AL",
            "license": "14864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2016; 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.