Organization Active NPI

Knee Regeneration and Advanced Healthcare of St George

  • Nurse Practitioner
  • Saint George, UT
National Provider Identifier
1316650666
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
KNEE REGENERATION AND ADVANCED HEALTHCARE OF ST GEORGE
Practice address
640 E 700 S Ste 206
Saint George, UT 84770-5732
Phone
(928) 607-0407
NPI assigned
Jan 3, 2023
Organization subpart
Yes
Parent organization
KNEE REGENERATION AND ADVANCED HEALTHCARE OF ST GEORGEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 22, 2023

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

Authorized official

Name
Tim Shinkle
Title
Clinic Owner
Phone
(928) 607-0407

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

640 E 700 S Ste 206
Saint George, UT 84770-5732

Mailing address

640 E 700 S Ste 206
Saint George, UT 84770-5732
Phone (928) 607-0407

Other names 1

  • Utah Knee and Joint Clinic Doing business as

National Provider Directory

National Provider Directory
Part of
Knee Regeneration and Advanced Healthcare of St George

Locations

640 E 700 S
Ste 206
St George, UT 84770
Phone (435) 773-6600

NPI Registry JSON

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

{
    "created_epoch": "1672704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684713600000",
    "number": "1316650666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 E 700 S STE 206",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847705732",
            "telephone_number": "928-607-0407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 E 700 S STE 206",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847705732",
            "telephone_number": "928-607-0407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNEE REGENERATION AND ADVANCED HEALTHCARE OF ST GEORGE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KNEE REGENERATION AND ADVANCED HEALTHCARE OF ST GEORGE",
        "enumeration_date": "2023-01-03",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A",
        "authorized_official_last_name": "SHINKLE",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "CLINIC OWNER",
        "authorized_official_telephone_number": "928-607-0407"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Utah Knee and Joint Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; 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.