Regenerative Health 360 LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

REGENERATIVE HEALTH 360 LLC

Practice address

1650 Skylyn Dr Ste 420
Spartanburg, SC 29307-1086

Phone

(864) 208-9138

Fax

(864) 308-8325

NPI assigned

Feb 10, 2020

Organization subpart

No

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

Authorized official

Name

Cheryl Rivers

Title

Cfo

Phone

(864) 606-7764

Specialties & licenses 1

Addresses

Other names 1

• REGENERATIVE HEALTH 360 Doing business as

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633651200000",
    "number": "1649802497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 SKYLYN DR STE 420",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293071047",
            "telephone_number": "864-464-7985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 SKYLYN DR STE 420",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293071086",
            "telephone_number": "864-208-9138",
            "fax_number": "864-308-8325"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "429 Roper Mountain Rd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296154265",
            "country_code": "US",
            "telephone_number": "864-351-2211",
            "fax_number": "864-351-2230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REGENERATIVE HEALTH 360 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-10",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A",
        "authorized_official_last_name": "RIVERS",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "864-606-7764"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "REGENERATIVE HEALTH 360",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "REGENERATIVE HEALTH 360",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Spartanburg, SC
• Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2021; 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.