Active NPI
North Glendale Regenerative Medicine PLLC
- Pain Clinic/Center
- Glendale, AZ
National Provider Identifier
1083318604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Clinic/Center
- Legal business name
- NORTH GLENDALE REGENERATIVE MEDICINE PLLC
- Practice address
- 18301 N 79TH Ave Ste F168
Glendale, AZ 85308-6045 - Phone
- (623) 544-9090
- NPI assigned
- Mar 28, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Seth Clark, DPM
- Title
- Owner
- Phone
- (623) 544-9090
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Clinic/Center | 261QP3300X | Primary |
Addresses
Primary practice location
18301 N 79TH Ave Ste F168
Glendale, AZ 85308-6045
Mailing address
18301 N 79TH Ave Ste F168
Glendale, AZ 85308-6045
Phone (623) 544-9090
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679961600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1679961600000",
"number": "1083318604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18301 N 79TH AVE STE F168",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853086045",
"telephone_number": "623-544-9090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18301 N 79TH AVE STE F168",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853086045",
"telephone_number": "623-544-9090"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTH GLENDALE REGENERATIVE MEDICINE PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-03-28",
"last_updated": "2023-03-28",
"certification_date": "2023-03-28",
"status": "A",
"authorized_official_last_name": "CLARK",
"authorized_official_first_name": "SETH",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "623-544-9090",
"authorized_official_credential": "DPM"
},
"taxonomies": [
{
"code": "261QP3300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Pain",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Glendale, AZ
- Rudy Noriega, PAC
- Brandi Norman
- Elizabeth Norman
- North Family Medicine LTD
- North Glendale Regenerative Medicine Clinic PLLC
- North Valley Ear, Nose & Throat Associates, P.C
- North Valley Emergency Specialists
- North Valley Family Medicine PC
- North Valley Surgical Associates, PC
- Steven Cleo Northern Jr., FNP-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.