Organization Active NPI

Rejuvenate Medical LLC

  • General Practice Physician
  • Lees Summit, MO
National Provider Identifier
1881101434
Registry record updated Jan 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
REJUVENATE MEDICAL LLC
Practice address
400 SW Longview Blvd Ste 160
Lees Summit, MO 64081-2112
Phone
(816) 761-3944
NPI assigned
Jan 4, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2018

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

Authorized official

Name
Joseph SymesNPI 1336237189
Title
Partner/Authorized Official
Phone
(816) 761-3944

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

400 SW Longview Blvd Ste 160
Lees Summit, MO 64081-2112

Mailing address

400 SW Longview Blvd Ste 160
Lees Summit, MO 64081-2112

National Provider Directory

National Provider Directory

Locations

400 SW Longview Blvd
Ste 1
Lees Summit, MO 64081
Phone (816) 761-3944

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1515024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515110400000",
    "number": "1881101434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SW LONGVIEW BLVD STE 160",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640812112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SW LONGVIEW BLVD STE 160",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640812112",
            "telephone_number": "816-761-3944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REJUVENATE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-04",
        "last_updated": "2018-01-05",
        "status": "A",
        "authorized_official_last_name": "SYMES",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "PARTNER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "816-761-3944"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lees Summit, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2018; 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.