Atlantic Knee Restoration & Regenerative Medicine - Reston

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

Legal business name

ATLANTIC KNEE RESTORATION & REGENERATIVE MEDICINE - RESTON

Practice address

106 Elden St Ste 10
Herndon, VA 20170-4826

Phone

(703) 854-1432

NPI assigned

Jul 19, 2021

Organization subpart

No

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

Authorized official

Name

Robert Crittenden III

Title

Owner

Phone

(256) 302-2228

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664323200000",
    "number": "1376116343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7481 RIGHT FLANK RD STE 100",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231163838",
            "telephone_number": "804-877-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 ELDEN ST STE 10",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704826",
            "telephone_number": "703-854-1432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC KNEE RESTORATION & REGENERATIVE MEDICINE - RESTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-19",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A",
        "authorized_official_last_name": "CRITTENDEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-302-2228",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Herndon, VA
• Providers in Herndon, VA by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.