NPIMap

Organization Active NPI

Goodwin Elite Orthobiologics and Wellness PLLC

Doing business as Regenexx Las Vegas

  • Physical Medicine & Rehabilitation Physician
  • Henderson, NV
National Provider Identifier
1366194862
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
GOODWIN ELITE ORTHOBIOLOGICS AND WELLNESS PLLC
Doing business as
Regenexx Las Vegas
Practice address
100 N Green Valley Pkwy Ste 325
Henderson, NV 89074-6393
Phone
(702) 722-6030
NPI assigned
Jan 25, 2022
Last updated
May 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Authorized official

Name
Sandy Friday, CTP
Title
Credentilaer
Phone
(702) 800-8988

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X Primary

Addresses

Primary practice location

100 N Green Valley Pkwy Ste 325
Henderson, NV 89074-6393

Mailing address

100 N Green Valley Pkwy Ste 325
Henderson, NV 89074-6393
Phone (702) 722-6030

Other names 1

  • Regenexx Las Vegas Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1643068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652832000000",
    "number": "1366194862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N GREEN VALLEY PKWY STE 325",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890746393",
            "telephone_number": "702-722-6030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N GREEN VALLEY PKWY STE 325",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890746393",
            "telephone_number": "702-722-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODWIN ELITE ORTHOBIOLOGICS AND WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-25",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A",
        "authorized_official_last_name": "FRIDAY",
        "authorized_official_first_name": "SANDY",
        "authorized_official_title_or_position": "CREDENTILAER",
        "authorized_official_telephone_number": "702-800-8988",
        "authorized_official_credential": "CTP"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regenexx Las Vegas",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Regenexx Las Vegas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; 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.