Hydraspa Rejuvenation Station LLC

Primary specialty

Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X

Legal business name

HYDRASPA REJUVENATION STATION LLC

Practice address

11 Union St S Ste 105
Concord, NC 28025-5088

Phone

(980) 310-6381

NPI assigned

Jan 28, 2025

Last updated

Jan 28, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Monique Lucas, RNNPI 1336432533

Title

Chief Nursing Officer

Phone

(980) 310-6381

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Monique Nicole Lucas, RN

  • Home Health Registered Nurse
  • Concord, NC
  • NPI 1336432533
  NPD Authorized official

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

{
    "created_epoch": "1738022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738022400000",
    "number": "1881407450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10301 WINDTREE LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282159019",
            "telephone_number": "980-310-6381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 UNION ST S STE 105",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280255088",
            "telephone_number": "980-310-6381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HYDRASPA REJUVENATION STATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-28",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A",
        "authorized_official_last_name": "LUCAS",
        "authorized_official_first_name": "MONIQUE",
        "authorized_official_title_or_position": "CHIEF NURSING OFFICER",
        "authorized_official_telephone_number": "980-310-6381",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deanna Hutcherson
• Billie Gragg Hutchison, L.P.N
• Karla Hutchison, MSW, LCAS-A, CFMHE
• Emily Hyatt, DMD
• Emily Hyde, MS CCC-SLP
• Leslie Ibarra Rivas
• Icare Management LLC
• Edna Obehi Idehen, NP
• Ayah Idlibi
• James Nelson Iglehart, M.D.

• Infusion Therapy Clinic/Center in Concord, NC
• Providers in Concord, NC by specialty
• Infusion Therapy Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; 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.