Regenerate Therapy Services LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

REGENERATE THERAPY SERVICES LLC

Practice address

6301 Lincoln Hwy
Matteson, IL 60443

Phone

(815) 905-1172

NPI assigned

Feb 5, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Gavin Weir III, PT, DPTNPI 1447804687

Title

Managing Director

Phone

(312) 857-8180

Specialties & licenses 1

Addresses

Other names 1

• Regenerate Therapy Services Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gavin Weir III, PT, DPT, CSCS

  • Physical Therapist
  • Frankfort, IL
  • NPI 1447804687
  NPD Authorized official

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

{
    "created_epoch": "1612483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612483200000",
    "number": "1265024848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17200 OAK PARK AVE UNIT 306",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604773639",
            "telephone_number": "312-857-8180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 LINCOLN HWY",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "60443",
            "telephone_number": "815-905-1172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENERATE THERAPY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-05",
        "last_updated": "2021-02-05",
        "certification_date": "2021-01-21",
        "status": "A",
        "authorized_official_last_name": "WEIR",
        "authorized_official_first_name": "GAVIN",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "312-857-8180",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regenerate Therapy Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Physical Therapy Clinic/Center in Matteson, IL
• Providers in Matteson, IL by specialty
• Physical Therapy Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.