LUMINOSITY INTEGRATED REJUVENATION
NPI 1073364170
Clinic/Center - Primary Care in Paintsville, KY
About Luminosity Integrated Rejuvenation NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LUMINOSITY INTEGRATED REJUVENATION (NPI 1073364170) is a healthcare organization registered as a primary care in Paintsville, Kentucky and active in the NPI registry since March 2024. The organization holds a CLIA Waiver certificate valid through March 13, 2027 and lists Jason Short, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Luminosity Integrated Rejuvenation is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Luminosity Integrated Rejuvenation, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 18D2320224
Luminosity Integrated Rejuvenation · Paintsville, KYFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Luminosity Integrated Rejuvenation's NPI number?
The NPI number for Luminosity Integrated Rejuvenation is 1073364170. It was assigned to this organization in the NPPES registry on March 28, 2024.
Where is Luminosity Integrated Rejuvenation located?
Luminosity Integrated Rejuvenation is located at 503 Depot Road, Paintsville, KY 41240. The listed phone number is (606) 793-5077.
What is Luminosity Integrated Rejuvenation's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Luminosity Integrated Rejuvenation enrolled in Medicare?
Yes. Luminosity Integrated Rejuvenation is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Luminosity Integrated Rejuvenation?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Luminosity Integrated Rejuvenation. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Luminosity Integrated Rejuvenation hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 18D2320224) is associated with this NPI, valid through March 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Luminosity Integrated Rejuvenation was last updated on March 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Luminosity Integrated Rejuvenation · NPI 1073364170
Primary Care organization in Paintsville, Kentucky. Organization record, active in the CMS NPPES registry since March 28, 2024.
## Identity
- **NPI:** 1073364170 (Entity type: Organization)
- **Enumerated:** March 28, 2024
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Jason Short, OWNER
## Practice location
- **Address:** 503 DEPOT ROAD, Paintsville, KY 41240
- **Phone:** (606) 793-5077
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 28, 2024
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1073364170) · Data from the CMS NPPES public registry.