Organization Active NPI

Medical Center for Joint Restoration and Regenerative Medicine, LLC

  • Family Medicine Physician
  • Bloomington, IN
National Provider Identifier
1194316596
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
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

Updated by the provider on Jun 29, 2021

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)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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 Directory

Locations

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.

Verify at the official NPI Registry.