NPI Code Detail JSON Logo

1144043951 NPI number — REJUV WELLNESS & DIAGNOSTICS

NPI Number: 1144043951
Health Care Provider/Practitioner: REJUV WELLNESS & DIAGNOSTICS

Information about “1144043951” NPI (REJUV WELLNESS & DIAGNOSTICS) exists in 1144043951 in HTML format HTML  |  1144043951 in plain Text format TXT  |  1144043951 in PDF (Portable Document Format) PDF  |  1144043951 in an XML format XML  formats.

NPI Number : 1144043951 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1144043951",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "REJUV WELLNESS & DIAGNOSTICS",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "7806 SILVER MIST AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "NORTH CHESTERFIELD",
    "MailingAddressStateName": "VA",
    "MailingAddressPostalCode": "23237-1976",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "804-586-6855",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "10020 CHESTER RD STE A",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CHESTER",
    "PracticeLocationAddressStateName": "VA",
    "PracticeLocationAddressPostalCode": "23831-1112",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "804-635-3065",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "11/01/2024",
    "LastUpdateDate": "01/10/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "COLEMAN",
    "AuthorizedOfficialFirstName": "ELISHA",
    "AuthorizedOfficialMiddleName": "J",
    "AuthorizedOfficialTitle": "CEO",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "804-586-6855",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "261QH0100X",
          "TaxonomyName": "Health Service Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QI0500X",
          "TaxonomyName": "Infusion Therapy Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225700000X",
          "TaxonomyName": "Massage Therapist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261Q00000X",
          "TaxonomyName": "Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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