Active NPI
Medical Center for Joint Restoration and Regenerative Medicine, LLC
- Family Medicine Physician
- Bloomington, IN
National Provider Identifier
1194316596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- MEDICAL CENTER FOR JOINT RESTORATION AND REGENERATIVE MEDICINE, LLC
- Practice address
- 3900 S Walnut St Ste a
Bloomington, IN 47401-7331 - Phone
- (812) 822-1516
- NPI assigned
- Jan 28, 2021
- 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
- Ms. Erika Esther Giron
- Title
- Owner
- Phone
- (812) 822-1516
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
3900 S Walnut St Ste a
Bloomington, IN 47401-7331
Mailing address
3900 S Walnut St Ste a
Bloomington, IN 47401-7331
Phone (812) 822-1516
National Provider Directory
National Provider DirectoryLocations
1300 S Walnut St
Ste B
Bloomington, IN 47401
Phone (812) 369-5471
3900 S Walnut St
Ste A
Bloomington, IN 47401
Phone (812) 822-1516
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611792000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1624924800000",
"number": "1194316596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3900 S WALNUT ST STE A",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474017331",
"telephone_number": "812-822-1516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3900 S WALNUT ST STE A",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474017331",
"telephone_number": "812-822-1516"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEDICAL CENTER FOR JOINT RESTORATION AND REGENERATIVE MEDICINE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-01-28",
"last_updated": "2021-06-29",
"certification_date": "2021-05-12",
"status": "A",
"authorized_official_last_name": "GIRON",
"authorized_official_first_name": "ERIKA",
"authorized_official_middle_name": "ESTHER",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "812-822-1516",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.