REGENERATIVE WELLNESS CENTER, LLC (NPI# 1144694480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144694480 |
| Entity Type | Organization |
| Organization Name | REGENERATIVE WELLNESS CENTER, LLC |
| Practice Address |
8633 Mexico Rd O Fallon MO 63366-7506 |
| Practice Telephone | 6362728888 |
| Practice Fax Number | 6362727385 |
| Mailing Telephone | 6362728888 |
| Mailing Fax Number | 6362727385 |
| Enumeration Date | 2015-11-24 |
| Last Update Date | 2015-11-24 |
| Authorized Official Name | MICHAEL WILLIAMS (AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 6362728891 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 2009009432 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
8633 MEXICO RD |
| City | O FALLON |
| State | MO |
| Zip Code | 63366-7506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922098599 | Michael A Williams | Chiropractor | 8633 Mexico Rd, O Fallon, MO 63366-7506 | 2005-10-25 |
| 1952874620 | Kathleen Brooks | Nurse Practitioner | 8633 Mexico Rd, O Fallon, MO 63366-7506 | 2019-01-06 |
| 1033484795 | Physical Medicine Group, LLC | Internal Medicine | 8633 Mexico Rd, O Fallon, MO 63366-7506 | 2012-03-14 |
| 1902064223 | Michael A. Williams, Dc | Chiropractor | 8633 Mexico Rd, O Fallon, MO 63366-7506 | 2008-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407314826 | Transformative Health 180 LLC | Physical Therapist | 821 West Terra Lane, O Fallon, MO 63366 | 2019-03-05 |
| 1740754126 | Donna Marie Person | Nurse Practitioner | 331 Magnolia Valley Dr., Ofallon, MO 63366 | 2019-01-18 |
| 1679069470 | Samantha Schulte | Clinical Pharmacology | 7 Poor Richard Ct, O Fallon, MO 63366 | 2018-07-03 |
| 1790218048 | Jill Buery | Marriage & Family Therapist | 801 S Woodlawn Ave, Ste 15, O'fallon, MO 63366 | 2017-04-04 |
| 1114466968 | Jessica Anne Morris | Counselor | 103 Lincoln Street, O'fallon, MO 63366 | 2017-02-13 |
| 1639528540 | Kyle James Neuschaefer | Dentist | 31 Ofallon Sq, O Fallon, MO 63366 | 2016-06-10 |
| 1295116143 | Katherine Seiler Harkess | Obstetrics & Gynecology | 300 Winding Woods Drive Suite 200, O'fallon, MO 63366 | 2015-06-16 |
| 1528453354 | Amanda Flamm | Nurse Practitioner | 1101 Hightway K, Ofallon, MO 63366 | 2015-03-30 |
| 1144639972 | Sara Birkemeier | Physical Therapist | 1541 Norwood Hills Dr, Ofallon, MO 63366 | 2014-08-06 |
| 1710390893 | Catherine Rose Most | Speech-Language Pathologist | 555 E. Terra Lane, Fort Zumwalt School District, O'fallon, MO 63366 | 2014-06-06 |
| Find all providers in zip 63366 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477019909 | Family Medical Clinic Pllc | Family Medicine | 1480 N Green Mount Rd Suite 200, O Fallon, IL 62269-3466 | 2019-02-20 |
| 1700351822 | Justin Andrew Steinkamp | Family Medicine | 1002 Peruque Crossing Ct Ste 101, O Fallon, MO 63366-2381 | 2018-10-04 |
| 1912345935 | Jackson Charles Pugh | Family Medicine | 300 Winding Woods Dr Ste 100, O Fallon, MO 63366-5080 | 2013-06-12 |
| 1518228170 | Jaime Rebecca Obszanski | Family Medicine | 1414 Cross St Ste 210, O Fallon, IL 62269 | 2012-05-30 |
| 1427345263 | Alison Juliete Ball | Family Medicine | 2223 Technology Dr, Suite 40, O Fallon, MO 63368-7272 | 2011-06-30 |
| 1083824684 | Amy Elizabeth Grawey | Family Medicine | 207 E Pitman St, O Fallon, MO 63366-2620 | 2007-05-23 |
| 1104991017 | Rema Sanghavi | Family Medicine | 1512 N Green Mount Rd Ste 108, O Fallon, IL 62269 | 2006-11-24 |
| 1316025554 | Robert F Holloway | Family Medicine | 935 Green Briar Hills Dr, O Fallon, MO 63366-5596 | 2006-11-02 |
| 1245287085 | James Robert Lundy | Family Medicine | 320 E Highway 50, O Fallon, IL 62269-2704 | 2006-05-27 |
| 1083689061 | John J. O'brien | Family Medicine | 2630 Highway K, O Fallon, MO 63368-6624 | 2006-02-22 |
| Find all providers in O FALLON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.