Organization Active NPI

Regenerative Medicine and Pain Management Physicians PLLC

  • Interventional Pain Medicine Physician
  • Gulf Breeze, FL
National Provider Identifier
1245764554
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
ME42993 Issued in FL
Legal business name
REGENERATIVE MEDICINE AND PAIN MANAGEMENT PHYSICIANS PLLC
Practice address
3406 Santa Rosa Dr
Gulf Breeze, FL 32563-5665
Phone
(850) 462-4544
Fax
(850) 777-3166
NPI assigned
Apr 13, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Ruben Timmons, MDNPI 1376546572
Title
Owner
Phone
(850) 462-4544

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X ME42993 FL Primary

Addresses

Primary practice location

3406 Santa Rosa Dr
Gulf Breeze, FL 32563-5665

Mailing address

PO Box 30332
Pensacola, FL 32503-1332
Phone (850) 462-4544

Other practice location 1

1549 Airport Blvd Ste 440
Pensacola, FL 32504-8634
Phone (850) 462-4544

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170525001547 FL Part B Supplier - Clinic/Group Practice 6103193040 Receives reassigned benefits from 3 practitioners
Practice locations: Pensacola, FL; Gulf Breeze, FL

National Provider Directory

National Provider Directory

Locations

1645 Nantahala Beach Rd
Gulf Breeze, FL 32563
Phone (850) 438-1136

3406 Santa Rosa Dr
Gulf Breeze, FL 32563
Phone (850) 462-4544

120 E Main St
Ste B
Pensacola, FL 32502
Phone (734) 389-5832

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.

NPI Registry JSON

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

{
    "created_epoch": "1492041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1245764554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30332",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325031332",
            "telephone_number": "850-462-4544",
            "fax_number": "850-777-3166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3406 SANTA ROSA DR",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325635665",
            "telephone_number": "850-462-4544",
            "fax_number": "850-777-3166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1549 Airport Blvd Ste 440",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325048634",
            "country_code": "US",
            "telephone_number": "850-462-4544",
            "fax_number": "850-777-3166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REGENERATIVE MEDICINE AND PAIN MANAGEMENT PHYSICIANS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "TIMMONS",
        "authorized_official_first_name": "RUBEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-462-4544",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "FL",
            "license": "ME42993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulf Breeze, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.