Regenesis Health Service Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

1789 Issued in FL

Legal business name

REGENESIS HEALTH SERVICE INC.

Doing business as

St. John's Medical

Practice address

582 Cherry Dr
Waconia, MN 55387-4578

Phone

(888) 431-9444

Fax

(888) 430-8776

NPI assigned

Jun 12, 2006

Last updated

Aug 23, 2016By 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

Mr. John Mark Blosser, BSW

Title

President / General Manager

Phone

(903) 357-3391

Specialties & licenses 1

Addresses

Other names 1

• St. John's Medical Doing business as

Locations

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471910400000",
    "number": "1992747224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "582 CHERRY DR",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553874578",
            "telephone_number": "888-431-9444",
            "fax_number": "888-430-8776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "582 CHERRY DR",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553874578",
            "telephone_number": "888-431-9444",
            "fax_number": "888-430-8776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENESIS HEALTH SERVICE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2016-08-23",
        "status": "A",
        "authorized_official_last_name": "BLOSSER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT / GENERAL MANAGER",
        "authorized_official_telephone_number": "903-357-3391",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BSW"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "1789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. John's Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Waconia, MN
• Providers in Waconia, MN by specialty
• Durable Medical Equipment & Medical Supplies in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2016; 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.