NPIMap

Organization Active NPI

Regenerative Health 360 LLC

  • Clinic/Center
  • Myrtle Beach, SC
National Provider Identifier
1912598707
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
REGENERATIVE HEALTH 360 LLC
Practice address
4610 Oleander Dr Ste 102
Myrtle Beach, SC 29577-5752
Phone
(843) 945-9803
NPI assigned
Feb 3, 2021
Last updated
Feb 3, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

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

Authorized official

Name
Jeffrey Jones
Title
Ceo
Phone
(864) 464-7985

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

4610 Oleander Dr Ste 102
Myrtle Beach, SC 29577-5752

Mailing address

1650 Skylyn Dr Ste 420
Spartanburg, SC 29307-1047
Phone (864) 464-7985

National Provider Directory

National Provider Directory
Tax ID family
Amnesty Health Group5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1612310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612310400000",
    "number": "1912598707",
    "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",
            "fax_number": "864-308-3825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4610 OLEANDER DR STE 102",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775752",
            "telephone_number": "843-945-9803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENERATIVE HEALTH 360 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-03",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "864-464-7985"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.