Regenerative Institute of Wellesley PC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

REGENERATIVE INSTITUTE OF WELLESLEY PC

Practice address

422 Worcester St Ste 303
Wellesley Hills, MA 02481-5341

Phone

(781) 489-5427

NPI assigned

Nov 16, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ethan Kellum

Title

Owner

Phone

(781) 489-5427

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1637020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644192000000",
    "number": "1003572827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 WORCESTER ST STE 303",
            "city": "WELLESLEY HILLS",
            "state": "MA",
            "postal_code": "024815341",
            "telephone_number": "781-489-5427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 WORCESTER ST STE 303",
            "city": "WELLESLEY HILLS",
            "state": "MA",
            "postal_code": "024815341",
            "telephone_number": "781-489-5427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENERATIVE INSTITUTE OF WELLESLEY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-16",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A",
        "authorized_official_last_name": "KELLUM",
        "authorized_official_first_name": "ETHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-489-5427"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Talya Rabina, PSY.D.
• Raquel K. Perlis Physical Therapy, Inc.
• Robert Earl Reifsnyder, EDD
• Retina Specialists of Boston and Wellesley LLC
• Samantha Reyes
• Paul Arthur Richer, MD
• Mackenzie Lynn Rickert, MS, OTR/L

• Orthopaedic Surgery Physician in Wellesley Hills, MA
• Providers in Wellesley Hills, MA by specialty
• Orthopaedic Surgery Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.