Organization Active NPI

Rejuvenation Wellness Center PLLC

  • Chiropractor
  • Phoenix, AZ
National Provider Identifier
1437316197
Registry record updated Aug 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
REJUVENATION WELLNESS CENTER PLLC
Practice address
4730 E Warner Rd Ste 10
Phoenix, AZ 85044-3320
Phone
(480) 785-4959
NPI assigned
May 20, 2008
Last updated
Aug 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2008

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

Authorized official

Name
Dr. Timothy O'Connor, D.C
Title
Owner / Doctor
Phone
(480) 785-4959

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X 5031 AZ
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

4730 E Warner Rd Ste 10
Phoenix, AZ 85044-3320

Mailing address

4730 E Warner Rd
Ste 10
Phoenix, AZ 85044-3320
Phone (480) 785-4959

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219190400000",
    "number": "1437316197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4730 E WARNER RD",
            "address_2": "STE 10",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850443320",
            "telephone_number": "480-785-4959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4730 E WARNER RD STE 10",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850443320",
            "telephone_number": "480-785-4959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REJUVENATION WELLNESS CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-20",
        "last_updated": "2008-08-20",
        "status": "A",
        "authorized_official_last_name": "O'CONNOR",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "OWNER / DOCTOR",
        "authorized_official_telephone_number": "480-785-4959",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "AZ",
            "license": "5031",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2008; 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.