Organization Active NPI

Rejuvenation Center LLC

  • Anesthesiology Physician
  • Tampa, FL
National Provider Identifier
1194711978
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
REJUVENATION CENTER LLC
Practice address
13904 N Dale Mabry Hwy
Suite 200
Tampa, FL 33618-2446
Phone
(813) 908-2020
Fax
(813) 908-2133
NPI assigned
Sep 27, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Authorized official

Name
Thomas H Newsom, MDNPI 1851386395
Title
Manager
Phone
(813) 908-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X Primary

Addresses

Primary practice location

13904 N Dale Mabry Hwy
Suite 200
Tampa, FL 33618-2446

Mailing address

13904 N Dale Mabry Hwy
Suite 200
Tampa, FL 33618-2446
Phone (813) 908-2020

Other practice location 1

4211 US Highway 27 N
Sebring, FL 33870
Phone (863) 382-7588

Other names 1

  • Newsom Cosmetic LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250904004235 FL Part B Supplier - Clinic/Group Practice 6800823659 Receives reassigned benefits from 2 practitioners
Practice locations: Tampa, FL

National Provider Directory

National Provider Directory

Locations

3207 Physicians Way
Ste A
Sebring, FL 33870
Phone (863) 382-7588

3207 Physicians Way
Sebring, FL 33870

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1194711978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13904 N DALE MABRY HWY",
            "address_2": "SUITE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182446",
            "telephone_number": "813-908-2020",
            "fax_number": "813-908-2133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13904 N DALE MABRY HWY",
            "address_2": "SUITE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182446",
            "telephone_number": "813-908-2020",
            "fax_number": "813-908-2133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4211 US Highway 27 N",
            "address_purpose": "LOCATION",
            "city": "Sebring",
            "state": "FL",
            "postal_code": "33870",
            "country_code": "US",
            "telephone_number": "863-382-7588",
            "fax_number": "863-385-1233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REJUVENATION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-27",
        "last_updated": "2025-09-02",
        "certification_date": "2025-07-03",
        "status": "A",
        "authorized_official_last_name": "NEWSOM",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "813-908-2020",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Newsom Cosmetic LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; 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.