Modern Rejuvenation Center, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MODERN REJUVENATION CENTER, LLC

Practice address

11495 N Penn St Ste 100
Carmel, IN 46032-6200

Phone

(317) 827-6326

Fax

(317) 827-6328

NPI assigned

Apr 21, 2021

Organization subpart

No

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

Authorized official

Name

Antonio Senat, MD

Title

Owner

Phone

(317) 827-6326

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621382400000",
    "number": "1174105035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11495 N PENN ST STE 100",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460326200",
            "telephone_number": "317-827-6326",
            "fax_number": "317-827-6328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11495 N PENN ST STE 100",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460326200",
            "telephone_number": "317-827-6326",
            "fax_number": "317-827-6328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN REJUVENATION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-21",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A",
        "authorized_official_last_name": "SENAT",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-827-6326",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Q Mitchell, MD
• Jennifer Mitchell
• Stevan Mizimakoski, R.PH.
• Sina L. Moainie, MD
• Jean-Pierre Mobasser, MD
• George Thomas Moffat, PHARMD
• Heidi Moffatt, LMHC
• Kimberly Moffett, LCSW
• Kenneth K Moghadam, M.D.
• Nazar Mohammad, MD

• Family Medicine Physician in Carmel, IN
• Providers in Carmel, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; 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.