Regenerative Medicine of Iowa PC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

REGENERATIVE MEDICINE OF IOWA PC

Practice address

2910 Westown Pkwy Ste 200
West Des Moines, IA 50266-1332

Phone

(515) 223-7773

Fax

(949) 543-2399

NPI assigned

Oct 19, 2022

Organization subpart

No

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

Authorized official

Name

Michael Jackson, MDNPI 1659590735

Title

Owner

Phone

(515) 223-7773

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Locations

Practitioners 1

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

• Michael Doniel Jackson, M.D

  • Physical Medicine & Rehabilitation Physician
  • Saint Paul, MN
  • NPI 1659590735

  IA

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1666137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666137600000",
    "number": "1346966587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 WESTOWN PKWY STE 200",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661332",
            "telephone_number": "515-223-7773",
            "fax_number": "949-543-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 WESTOWN PKWY STE 200",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661332",
            "telephone_number": "515-223-7773",
            "fax_number": "949-543-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENERATIVE MEDICINE OF IOWA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-19",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "515-223-7773",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Wade Reents, PT
• Derek Rees, PHARMD
• Eric Reese, DPM
• Ashlee J Reetz, PA
• Regency Nursing Services, Inc.
• Rehabvisions Therapy NE, LLC
• Derek Reicks, DC
• Alexander John Arnold Reif, PT
• Tara Reinders, PT
• Amy Lee Reinert, ARNP

• Physical Medicine & Rehabilitation Physician in West Des Moines, IA
• Providers in West Des Moines, IA by specialty
• Physical Medicine & Rehabilitation Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; 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.