South Denver Regen Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

SOUTH DENVER REGEN INC

Practice address

8765 E Orchard Rd Ste 702
Greenwood Village, CO 80111-5009

Phone

(303) 738-0390

Fax

(866) 238-2721

NPI assigned

May 15, 2020

Organization subpart

No

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

Authorized official

Name

Shawn Johonnesson

Title

President

Phone

(303) 738-0390

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1589500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589500800000",
    "number": "1962024653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8765 E ORCHARD RD STE 702",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801115009",
            "telephone_number": "303-738-0390",
            "fax_number": "866-238-2721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8765 E ORCHARD RD STE 702",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801115009",
            "telephone_number": "303-738-0390",
            "fax_number": "866-238-2721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH DENVER REGEN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-15",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A",
        "authorized_official_last_name": "JOHONNESSON",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-738-0390"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Greenwood Village, CO
• Providers in Greenwood Village, CO by specialty
• Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2020; 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.