NPIMap

Organization Active NPI

Rejuvinix, LLC

  • Physical Medicine & Rehabilitation Physician
  • Virginia Beach, VA
National Provider Identifier
1710409529
Registry record updated Dec 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
REJUVINIX, LLC
Practice address
4701 Columbus St
Virginia Beach, VA 23462-6725
Phone
(414) 736-1317
NPI assigned
Jul 13, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2018

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

Authorized official

Name
Richard Salinas, RN
Title
Ceo
Phone
(414) 736-1317

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Rheumatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RR0500X
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081S0010X
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X
Sports Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251S0007X

Addresses

Primary practice location

4701 Columbus St
Virginia Beach, VA 23462-6725

Mailing address

409 Courage Way
Virginia Beach, VA 23451-5594
Phone (414) 736-1317

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170911001504 VA Part B Supplier - Clinic/Group Practice 0345513537 Receives reassigned benefits from 12 practitioners
Practice locations: Richmond, VA; Virginia Beach, VA
O20171206000699 VA DME Supplier - Physician - Physical and Rehabilitation 0345513537 Practice locations: Virginia Beach, VA

National Provider Directory

National Provider Directory

Locations

7301 Forest Ave
Ste 204
Richmond, VA 23226
Phone (804) 506-3069

4701 Columbus St
Ste 100
Virginia Beach, VA 23462
Phone (414) 736-1317

4417 Corporation Ln
Ste 150
Virginia Beach, VA 23462

4701 Columbus St
Virginia Beach, VA 23462
Phone (414) 736-1317

15255 Watertown Plank Rd
Ste 200
Elm Grove, WI 53122
Phone (414) 736-1317

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545177600000",
    "number": "1710409529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 COURAGE WAY",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234515594",
            "telephone_number": "414-736-1317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 COLUMBUS ST",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234626725",
            "telephone_number": "414-736-1317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REJUVINIX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-13",
        "last_updated": "2018-12-19",
        "status": "A",
        "authorized_official_last_name": "SALINAS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "414-736-1317",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2018; 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.