Active NPI
Regeneration Nation LLC
- Family Medicine Physician
- Tulsa, OK
National Provider Identifier
1164060158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- REGENERATION NATION LLC
- Practice address
- 6565 S Yale Ave Ste 106
Tulsa, OK 74136-8302 - Phone
- (918) 481-2772
- NPI assigned
- Dec 20, 2019
- Last updated
- Mar 26, 2024
- 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
- Brian Roadhouse
- Title
- Owner, Authorized Official
- Phone
- (918) 481-2772
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | |||
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
6565 S Yale Ave Ste 106
Tulsa, OK 74136-8302
Mailing address
6565 S Yale Ave
Tulsa, OK 74136-8327
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
6565 S Yale Ave
Ste 106
Tulsa, OK 74136
Phone (918) 481-2770
Practitioners & affiliated clinicians
Practitioners 3
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.
-
- Chiropractor
- Tulsa, OK
- NPI 1477559201
-
- Anesthesiology Physician
- Oklahoma City, OK
- NPI 1295710846
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576800000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1711411200000",
"number": "1164060158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6565 S YALE AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "741368327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6565 S YALE AVE STE 106",
"city": "TULSA",
"state": "OK",
"postal_code": "741368302",
"telephone_number": "918-481-2772"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "REGENERATION NATION LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-12-20",
"last_updated": "2024-03-26",
"certification_date": "2024-03-26",
"status": "A",
"authorized_official_last_name": "ROADHOUSE",
"authorized_official_first_name": "BRIAN",
"authorized_official_title_or_position": "OWNER, AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "918-481-2772"
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Allergy & Immunology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; 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.