| Regenerative Medical And Wellness Centers, Llc | |
|
794 Highway 51 Ste D Madison MS 39110-9662 | |
| (601) 572-5564 | |
| Not Available |
| Full Name | Regenerative Medical And Wellness Centers, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 794 Highway 51 Ste D, Madison, Mississippi |
| Authorized Official Name and Position | Porsha Snyder (MEDICAL BILLING COORDINATOR) |
| Authorized Official Contact | 6013203553 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Regenerative Medical And Wellness Centers, Llc 794 Highway 51 Ste D Madison MS 39110-9662 Ph: (601) 572-5564 | Regenerative Medical And Wellness Centers, Llc 794 Highway 51 Ste D Madison MS 39110-9662 Ph: (601) 572-5564 |
| NPI Number | 1972349686 |
|---|---|
| Provider Enumeration Date | 07/02/2024 |
| Last Update Date | 07/02/2024 |
| Medicare PECOS PAC ID | 0042750176 |
|---|---|
| Medicare Enrollment ID | O20240904002422 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972349686 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Wayne C Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225087588 PECOS PAC ID: 5395813216 Enrollment ID: I20081006000312 |
| Provider Name | Tammy F Faulkner-craig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619275237 PECOS PAC ID: 6709054323 Enrollment ID: I20110725000751 |
| Provider Name | Amber Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699498774 PECOS PAC ID: 9133597255 Enrollment ID: I20221122000347 |
| Provider Name | Rebecca Leddy Emmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457035206 PECOS PAC ID: 8921455247 Enrollment ID: I20241011001852 |
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