Rejuvecare Clinic

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

REJUVECARE CLINIC

Practice address

77 3Rd Avenue West N
Kalispell, MT 59901-4049

Phone

(406) 240-7396

NPI assigned

Sep 11, 2015

Last updated

Sep 11, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shelley Smith Otoupalik

Title

Owner

Phone

(406) 240-7396

Specialties & licenses 1

Addresses

Locations

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.

• Shelley Smith Otoupalik, ACNP

  • Nurse Practitioner
  • Missoula, MT
  • NPI 1053407981
  NPD (past)

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

{
    "created_epoch": "1441929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441929600000",
    "number": "1285002923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7473 GROOMS RD",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598089798",
            "telephone_number": "406-240-7396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 3RD AVENUE WEST N",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599014049",
            "telephone_number": "406-240-7396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REJUVECARE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-11",
        "last_updated": "2015-09-11",
        "status": "A",
        "authorized_official_last_name": "SMITH OTOUPALIK",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-240-7396"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kynzie Reed
• Verne Reed, D.M.D
• Sandra Sue Reichhoff, M.A., C.R.C.
• Thomas J Reifers, MS LPC
• Rachel Reimnitz, RN, BSN, CCRN
• Mark C Remington, M.D.
• Heidi Love Rendina, NBCHWC
• Rhonda Leigh Vick, LCSW, LLC
• Alan Michael Rice, MD
• Kerianne Marie Richardson, MS, ATC, LAT

• Nurse Practitioner in Kalispell, MT
• Providers in Kalispell, MT by specialty
• Nurse Practitioner in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2015; 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.