NPIMap

Organization Active NPI

Regenerative Orthopedic Center LLC

  • Durable Medical Equipment & Medical Supplies
  • Oregon City, OR
National Provider Identifier
1124891635
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
REGENERATIVE ORTHOPEDIC CENTER LLC
Practice address
1508 Division St Ste 105
Oregon City, OR 97045-1584
Phone
(503) 656-0836
Fax
(503) 656-9464
NPI assigned
Nov 6, 2023
Last updated
Nov 6, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
REGENERATIVE ORTHOPEDIC CENTER LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Authorized official

Name
Amanda Koenig
Title
Coo
Phone
(503) 905-4102

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

1508 Division St Ste 105
Oregon City, OR 97045-1584

Mailing address

7111 SW Nyberg St
Tualatin, OR 97062-6245
Phone (503) 656-0836

National Provider Directory

National Provider Directory
Part of
Regenerative Orthopedic Center LLC

Locations

1508 Division St
Ste 105
Oregon City, OR 97045
Phone (503) 656-0836

7111 SW Nyberg St
Tualatin, OR 97062

Practitioners & affiliated clinicians

Practitioners 28

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.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699228800000",
    "number": "1124891635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7111 SW NYBERG ST",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970626245",
            "telephone_number": "503-656-0836",
            "fax_number": "503-656-9464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 DIVISION ST STE 105",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970451584",
            "telephone_number": "503-656-0836",
            "fax_number": "503-656-9464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENERATIVE ORTHOPEDIC CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "REGENERATIVE ORTHOPEDIC CENTER LLC",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A",
        "authorized_official_last_name": "KOENIG",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "503-905-4102"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oregon City, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.

Verify at the official NPI Registry.