Rejuvanation

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209005824 Issued in IL

Legal business name

REJUVANATION

Practice address

11 Currency Dr
Bloomington, IL 61704-9398

Phone

(309) 678-4243

NPI assigned

Dec 2, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Shawn C Snider, MSN

Title

CNP

Phone

(309) 278-0566

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1228176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228176000000",
    "number": "1629213814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 CURRENCY DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617049398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 CURRENCY DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617049398",
            "telephone_number": "309-678-4243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REJUVANATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-02",
        "last_updated": "2008-12-02",
        "status": "A",
        "authorized_official_last_name": "SNIDER",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CNP",
        "authorized_official_telephone_number": "309-278-0566",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209005824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Reichmuth
• Brian J Reilly, D.P.M.
• Benjamin Reinert, PT, DPT
• Rejuv Central PC
• Rejuv Integrative Medical Practice Shawn C Snider
• Revival Road Therapy PLLC
• RHC Investments, LLC - Bloomington Fox Creek Operations Series
• Kimberly Kelleher Rhoda, OT
• RHP Investments, LLC - Bloomington Towanda Operations Series
• Mara Rice, RBT

• Family Nurse Practitioner in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.