Organization Active NPI

Cellgen Regenerative Medicine LLC

  • General Practice Physician
  • Pooler, GA
National Provider Identifier
1386127801
Registry record updated Sep 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
CELLGEN REGENERATIVE MEDICINE LLC
Practice address
1147 US Highway 80 W
Pooler, GA 31322-2203
Phone
(912) 348-3146
Fax
(912) 748-1507
NPI assigned
Sep 11, 2018
Last updated
Sep 11, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2018

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

Authorized official

Name
Jennifer Ann Ranicki
Title
Owner
Phone
(912) 348-3146

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

1147 US Highway 80 W
Pooler, GA 31322-2203

Mailing address

1147 US Highway 80 W
Pooler, GA 31322-2203
Phone (912) 348-3146

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536624000000",
    "number": "1386127801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1147 US HIGHWAY 80 W",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313222203",
            "telephone_number": "912-348-3146",
            "fax_number": "912-748-1507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1147 US HIGHWAY 80 W",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313222203",
            "telephone_number": "912-348-3146",
            "fax_number": "912-748-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CELLGEN REGENERATIVE MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-11",
        "last_updated": "2018-09-11",
        "status": "A",
        "authorized_official_last_name": "RANICKI",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-348-3146"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pooler, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; 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.