NPIMap

Organization Active NPI

Regen Plus Inc

  • Clinic/Center
  • Glendale, AZ
National Provider Identifier
1306551569
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
REGEN PLUS INC
Practice address
20229 N 67TH Ave Ste C1A
Glendale, AZ 85308-6404
Phone
(602) 595-7836
Fax
(602) 419-2210
NPI assigned
Jan 20, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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

Authorized official

Name
Stephanie Knox
Title
Administration
Phone
(602) 290-5200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

20229 N 67TH Ave Ste C1A
Glendale, AZ 85308-6404

Mailing address

5562 W Arrowhead Lakes Dr
Glendale, AZ 85308-6293
Phone (602) 290-5200

Other identifiers 2

IdentifierTypeStateIssuer
1053742197MedicaidAZ
1770088205MedicaidAZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1674172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674172800000",
    "number": "1306551569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5562 W ARROWHEAD LAKES DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086293",
            "telephone_number": "602-290-5200",
            "fax_number": "602-419-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20229 N 67TH AVE STE C1A",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086404",
            "telephone_number": "602-595-7836",
            "fax_number": "602-419-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGEN PLUS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-20",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A",
        "authorized_official_last_name": "KNOX",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "ADMINISTRATION",
        "authorized_official_telephone_number": "602-290-5200"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053742197",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770088205",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; 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.