REGENCY RECONSTRUCTION PLLC (NPI# 1972086924) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972086924 |
| Entity Type | Organization |
| Organization Name | REGENCY RECONSTRUCTION PLLC |
| Practice Address |
10240 W Indian School Rd Ste 115 Phoenix AZ 85037-5905 |
| Practice Telephone | 6232516431 |
| Mailing Telephone | 6232516431 |
| Enumeration Date | 2018-09-14 |
| Last Update Date | 2019-06-11 |
| Authorized Official Name | JASON MUSSMAN (OWNER) |
| Authorized Official Telephone | 9892554794 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 961095 | 05 |
| Street Address |
10240 W INDIAN SCHOOL RD STE 115 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85037-5905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417906280 | Betty A Hinderks Davis | Dermatology | 10240 W Indian School Rd Ste 115, Phoenix, AZ 85037-5905 | 2006-05-09 |
| 1770180960 | Elyse Renee Broucek | Physician Assistant | 10240 W Indian School Rd Ste 115, Phoenix, AZ 85037-5905 | 2020-10-01 |
| 1720545239 | Brittany Dawn Silverman | Physician Assistant | 10240 W Indian School Rd Ste 115, Phoenix, AZ 85037-5905 | 2019-02-21 |
| 1215455753 | Stephanie Spahr | Physician Assistant | 10240 W Indian School Rd Ste 115, Phoenix, AZ 85037-5905 | 2017-09-05 |
| 1356791461 | Caroline Carr | Dermatology | 10240 W Indian School Rd Ste 115, Phoenix, AZ 85037-5905 | 2016-06-20 |
| 1508250432 | Benjamin Blaine Jones | Dermatology | 10240 W Indian School Rd Ste 115, Phoenix, AZ 85037-5905 | 2015-03-28 |
| 1124377767 | Melanie Renae Crutchfield Whitten | Surgery | 10240 W Indian School Rd Ste 115, Phoenix, AZ 85037-5905 | 2012-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356969828 | Live Well Assisted Living LLC | Psychiatric Residential Treatment Facility | 9210 W Loow Bend Lane, Phoenix, AZ 85037 | 2020-07-10 |
| 1770126260 | Medical Management Systems, Inc. | Assisted Living Facility | 2209 N. Rascon Loop, Phoenix, AZ 85037 | 2019-10-28 |
| 1346800760 | Sonoran Sky Family Dentistry | Dentist | 9515 West Camelback Road, Suite #120, Phoenix, AZ 85037 | 2019-06-18 |
| 1578025136 | Jennifer Natasha Kunz | Nurse Practitioner | Cleanslate, 8410 W. Thomas Rd, Phoenix, AZ 85037 | 2019-04-03 |
| 1740751320 | Mariposa Phoenix Al Partners, Lp | Assisted Living Facility | 3100 N 91st Avenue, Phoenix, AZ 85037 | 2018-12-08 |
| 1417442799 | Prop Anesthesia LLC | Nurse Anesthetist, Certified Registered | 9250 W Thomas Rd Ste 220, Phoenix, AZ 85037 | 2018-06-28 |
| 1922522242 | Tree of Life Mental Health Systems, LLC | Behavior Technician | 8400 W. Virginia, #1138, Phoenix, AZ 85037 | 2017-07-28 |
| 1720500465 | Moc Phoenix, LLC | Assisted Living Facility | 3000 N. 91st Avenue, Phoenix, AZ 85037 | 2017-07-14 |
| 1407385826 | Not Alone Home Care, LLC | In Home Supportive Care | 9422 W Palm Lane, Phoenix, AZ 85037 | 2017-06-08 |
| 1063953081 | Karla Soward | Radiologic Technologist | 2015 N Rascon Loop, Phoenix, AZ 85037 | 2017-03-09 |
| Find all providers in zip 85037 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144430182 | Jason Lee Mussman | Surgery | 10240 W. Indian School Rd., Suite 115, Phoenix, AZ 85037 | 2007-05-22 |
| 1801832977 | Tamir Mosharrafa | Surgery | 4611 E Shea Blvd Ste 230, Phoenix, AZ 85028 | 2006-06-20 |
| 1598705410 | Robert J Mcgregor | Surgery | 7601 N Central Ave, Unit 23, Phoenix, AZ 85020-4079 | 2006-06-08 |
| 1457303471 | Ali M Mosharrafa | Surgery | 4611 E Shea Blvd, Suite 230, Phoenix, AZ 85028-4254 | 2006-05-17 |
| 1730138561 | Travis C Holcombe | Surgery | 300 W Clarendon Ave Ste 440, Phoenix, AZ 85013-3420 | 2006-05-09 |
| 1104817378 | Barry Fernando | Surgery | 2777 E Camelback Rd Ste 140, #780, Phoenix, AZ 85016-4351 | 2005-11-04 |
| 1275521635 | Marc E Gottlieb | Surgery | 1012 E Willetta Street, Phoenix, AZ 85006 | 2005-10-10 |
| 1457969115 | Regenerative Institute Pllc | Surgery | 9250 N 3rd St Ste 1003, Phoenix, AZ 85020-2402 | 2020-07-20 |
| 1164058954 | Leland H Webb Md Plastic Surgery Plc | Surgery | 300 W Clarendon Ave Ste 440, Phoenix, AZ 85013-3476 | 2020-03-12 |
| 1508421819 | Phoenix Plastic Surgery, Pllc | Surgery | 9250 N 3rd St Ste 1003, Phoenix, AZ 85020-2402 | 2019-05-02 |
| Find all providers in PHOENIX | ||||
Please comment or provide details below to improve the information on REGENCY RECONSTRUCTION PLLC.
| 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.