Organization Active NPI

Regenerative Joint Clinics LLC

  • Medical Specialty Clinic/Center
  • Riverdale, GA
National Provider Identifier
1548838485
Registry record updated Aug 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
REGENERATIVE JOINT CLINICS LLC
Practice address
483 Upper Riverdale Rd SW Ste F
Riverdale, GA 30274-2579
Phone
(470) 895-0610
Fax
(706) 666-1325
NPI assigned
Jun 16, 2021
Last updated
Aug 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2026

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

Authorized official

Name
Jack Wright
Title
Managing Member
Phone
(470) 895-0610

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU
Medical Specialty Clinic/Center 261QM2500X NU Primary

Addresses

Primary practice location

483 Upper Riverdale Rd SW Ste F
Riverdale, GA 30274-2579

Mailing address

483 Upper Riverdale Rd SW Ste F
Riverdale, GA 30274-2579
Phone (470) 895-0610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210706002097 GA Part B Supplier - Clinic/Group Practice 8022410687 Receives reassigned benefits from 9 practitioners
Practice locations: Riverdale, GA

National Provider Directory

National Provider Directory

Locations

60 Oak Hill Blvd
#30
Newnan, GA 30265
Phone (470) 895-0610

Practitioners & affiliated clinicians

Practitioners 9

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": "1623801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786665600000",
    "number": "1548838485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 UPPER RIVERDALE RD SW STE F",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742579",
            "telephone_number": "470-895-0610",
            "fax_number": "706-666-1325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 UPPER RIVERDALE RD SW STE F",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742579",
            "telephone_number": "470-895-0610",
            "fax_number": "706-666-1325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENERATIVE JOINT CLINICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-16",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "470-895-0610"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverdale, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.