Organization Active NPI

Atlantic Knee Restoration & Regenerative Medicine - Richmond

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Mechanicsville, VA
National Provider Identifier
1093387748
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
Legal business name
ATLANTIC KNEE RESTORATION & REGENERATIVE MEDICINE - RICHMOND
Practice address
7481 Right Flank Rd Ste 100
Mechanicsville, VA 23116-3838
Phone
(256) 302-2228
NPI assigned
Jul 13, 2021
Last updated
Jul 7, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Authorized official

Name
Robert Trey Crittenden III
Title
Owner
Phone
(256) 302-2228

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X NU Primary

Addresses

Primary practice location

7481 Right Flank Rd Ste 100
Mechanicsville, VA 23116-3838

Mailing address

7481 Right Flank Rd Ste 100
Mechanicsville, VA 23116-3838

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210916001793 VA Part B Supplier - Clinic/Group Practice 3375940422 Receives reassigned benefits from 6 practitioners
Practice locations: Mechanicsville, VA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1626134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657152000000",
    "number": "1093387748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7481 RIGHT FLANK RD STE 100",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231163838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7481 RIGHT FLANK RD STE 100",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231163838",
            "telephone_number": "256-302-2228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC KNEE RESTORATION & REGENERATIVE MEDICINE - RICHMOND",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-13",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A",
        "authorized_official_last_name": "CRITTENDEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "TREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-302-2228",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mechanicsville, VA

Sources for this page

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

Verify at the official NPI Registry.