Rejuvenate Mens Health

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

REJUVENATE MENS HEALTH

Practice address

5131 S 1500 W
Riverdale, UT 84405-3926

Phone

(385) 500-9293

Fax

(385) 500-9274

NPI assigned

Mar 2, 2021

Organization subpart

No

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

Authorized official

Name

Justin Cowley, MBA, FACHE

Title

Managing Partner

Phone

(385) 500-9293

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1614643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614643200000",
    "number": "1841885803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 CHAMBERS ST STE 105",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844035085",
            "telephone_number": "385-500-9293",
            "fax_number": "385-500-9274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5131 S 1500 W",
            "city": "RIVERDALE",
            "state": "UT",
            "postal_code": "844053926",
            "telephone_number": "385-500-9293",
            "fax_number": "385-500-9274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REJUVENATE MENS HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-02",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A",
        "authorized_official_last_name": "COWLEY",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "385-500-9293",
        "authorized_official_credential": "MBA, FACHE"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krystal Pooler
• Shanquette Prophet, CSW
• Sara M Ramirez, HWC
• Katie Reed
• Julie Reeves
• Riverdale City Utah
• Genesis Rodriguez
• James Price Ronnow, LMFT
• Rooted Pines PLLC
• Amanda Rosen

• Family Medicine Physician in Riverdale, UT
• Providers in Riverdale, 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 Mar 2, 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.