Between the Lines Rejuvenation LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BETWEEN THE LINES REJUVENATION LLC

Practice address

1785 E Wilson Ave
Salt Lake City, UT 84108-2916

Phone

(877) 258-6331

Fax

(718) 362-1651

NPI assigned

Jan 29, 2024

Organization subpart

No

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

Authorized official

Name

Krista Corbett, NP

Title

Owner

Phone

(801) 694-1197

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1706486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721174400000",
    "number": "1396507984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 CORPORATE WAY STE 2M",
            "city": "VALLEY COTTAGE",
            "state": "NY",
            "postal_code": "109892027",
            "telephone_number": "718-362-1411",
            "fax_number": "718-362-1651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1785 E WILSON AVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841082916",
            "telephone_number": "877-258-6331",
            "fax_number": "718-362-1651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1349 E Cobble Creek Rd Apt 20H",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841177455",
            "country_code": "US",
            "telephone_number": "801-694-1197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BETWEEN THE LINES REJUVENATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-29",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A",
        "authorized_official_last_name": "CORBETT",
        "authorized_official_first_name": "KRISTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-694-1197",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rodney Betonney, MSW
• Brooke Betters
• Natalie Marie Bettez, MD
• Toni Bettino
• Robyn S Betts
• Courtney Beuning, D.O.
• Curtis C Bevan, D.D.S.
• Darion James Bevan, PHARMD
• Keith Bevan, TRS, CTRS
• Brittany Nicole Beverly

• Family Medicine Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; 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.