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REJUVENATION MEDSPA
NPI 1780158287
Family Medicine in Bridgeport, WV

Active since January 17, 2019
1400 JOHNSON AVE STE 4A, BRIDGEPORT, WV 26330(304) 848-9998(304) 848-9996 Get Directions Write a Review

NPPES record last updated: January 17, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Rejuvenation Medspa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

REJUVENATION MEDSPA (NPI 1780158287) is a healthcare organization registered as a family medicine in Bridgeport, West Virginia and active in the NPI registry since January 2019. The organization lists Timothy Michael Peasak, Owner/provider, as its authorized official.

NPPES Registry Identity

NPI1780158287
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameREJUVENATION MEDSPA
Location Address1400 JOHNSON AVE STE 4ABridgeport, WV 26330-1063
Mailing Address1400 Johnson Ave Ste 4aBridgeport, WV 26330-1063 · (304) 848-9998 · Fax (304) 848-9996
Phone(304) 848-9998
Fax(304) 848-9996
Organization SubpartNo
Authorized OfficialTimothy Michael PeasakOwner/provider · (304) 841-1293
Enumeration DateJanuary 17, 2019
✔ NPI 1780158287 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
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.
1400 JOHNSON AVE STE 4A, Bridgeport, WV 26330
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Other Identifiers 1

Other1942WV · Wv License Number

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Rejuvenation Medspa's NPI number?

The NPI number for Rejuvenation Medspa is 1780158287. It was assigned to this organization in the NPPES registry on January 17, 2019.

Where is Rejuvenation Medspa located?

Rejuvenation Medspa is located at 1400 Johnson Ave Ste 4A, Bridgeport, WV 26330. The listed phone number is (304) 848-9998.

What is Rejuvenation Medspa's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Rejuvenation Medspa was last updated on January 17, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.