REGENERISE HEALTH LLC
NPI 1083317390
Clinic/Center in Wallingford, CT
About Regenerise Health Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
REGENERISE HEALTH LLC (NPI 1083317390) is a healthcare organization registered as a clinic/center in Wallingford, Connecticut and active in the NPI registry since March 2023. The organization lists Authurine Hannam-davis, Family Nurse Practitioner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Regenerise Health Llc 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 Regenerise Health LLC, 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.
Frequently 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 Regenerise Health LLC's NPI number?
The NPI number for Regenerise Health LLC is 1083317390. It was assigned to this organization in the NPPES registry on March 24, 2023.
Where is Regenerise Health LLC located?
Regenerise Health LLC is located at 300 Church St, Wallingford, CT 06492. The listed phone number is (860) 994-7339.
What is Regenerise Health LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.
Is Regenerise Health LLC enrolled in Medicare?
Yes. Regenerise Health LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Regenerise Health LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Regenerise Health LLC. 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.
When was this NPI record last updated?
The NPPES record for Regenerise Health LLC was last updated on October 20, 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.
# Regenerise Health Llc · NPI 1083317390
Clinic/Center organization in Wallingford, Connecticut. Organization record, active in the CMS NPPES registry since March 24, 2023.
## Identity
- **NPI:** 1083317390 (Entity type: Organization)
- **Enumerated:** March 24, 2023
- **Primary specialty:** Clinic/Center · taxonomy 261Q00000X
- **Organization subpart:** No
- **Authorized official:** Authurine Hannam-Davis, FAMILY NURSE PRACTITIONER
## Practice location
- **Address:** 300 CHURCH ST, Wallingford, CT 06492-2253
- **Phone:** (860) 994-7339
## 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:** October 20, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1083317390) · Data from the CMS NPPES public registry.