MEDICARE: REGENERATIVE HEALTH AND WELLNESS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207VX0201X	Gynecologic Oncology Physician
2	2083B0002X	Obesity Medicine (Preventive Medicine) Physician
3	363LW0102X	Women's Health Nurse Practitioner
4	363LX0001X	Obstetrics & Gynecology Nurse Practitioner
5	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1780576942
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REGENERATIVE HEALTH AND WELLNESS, INC.

Provider Business Mailing Address
First Line	:	5731 SILVERSTONE TER STE 250
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80919-3545
Country	:	US
Telephone Number	:	719-635-0144
Fax Number	:

Provider Business Practice Location Address
First Line	:	5731 SILVERSTONE TER STE 250
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80919-3545
Country	:	US
Telephone Number	:	719-635-0144
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	JENNIFER HOLDREN
Credential	:
Telephone Number	:	719-635-0144

Provider Enumeration Date	:	07/21/2025
Last Update Date	:	07/21/2025

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