Organization Active NPI

Med Cell Regenerate

  • Multi-Specialty Clinic/Center
  • Maple Grove, MN
National Provider Identifier
1356956163
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
MED CELL REGENERATE
Doing business as
Med Cell Regenerate, LLC
Practice address
7373 Kirkwood CT N Ste 110
Maple Grove, MN 55369-5211
Phone
(763) 898-3517
NPI assigned
Sep 9, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

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

Authorized official

Name
Kristine Williams
Title
Cfo
Phone
(763) 898-3517

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

7373 Kirkwood CT N Ste 110
Maple Grove, MN 55369-5211

Mailing address

7373 Kirkwood CT N Ste 110
Maple Grove, MN 55369-5211
Phone (763) 898-3517

Other names 1

  • Med Cell Regenerate, LLC Doing business as

National Provider Directory

National Provider Directory

Locations

7373 Kirkwood Ct N
Ste 110
Maple Grove, MN 55369
Phone (763) 898-3517

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632873600000",
    "number": "1356956163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7373 KIRKWOOD CT N STE 110",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553695211",
            "telephone_number": "763-898-3517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7373 KIRKWOOD CT N STE 110",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553695211",
            "telephone_number": "763-898-3517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED CELL REGENERATE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-09",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "KRISTINE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "763-898-3517"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Med Cell Regenerate, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Maple Grove, MN

Sources for this page

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