Osteopathic Regenerative Medicine Center, LLC

Primary specialty

Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X

License

OS10979 Issued in FL

Legal business name

OSTEOPATHIC REGENERATIVE MEDICINE CENTER, LLC

Practice address

3915 Biscayne Blvd Ste 406
Miami, FL 33137-3737

Phone

(305) 367-1176

Fax

(877) 391-1611

NPI assigned

Jul 5, 2018

Organization subpart

No

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

Authorized official

Name

Kristopher Goddard, DONPI 1780910364

Title

Ownder

Phone

(305) 367-1176

Specialties & licenses 11

Addresses

Locations

Practitioners 6

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

• Kristopher Joseph Sean Goddard, D.O.

  • Sports Medicine (Family Medicine) Physician
  • Miami, FL
  • NPI 1780910364
  NPD Authorized official
• Benjamin Kosubevsky, DO

  • Family Medicine Physician
  • West Palm Beach, FL
  • NPI 1881250363
  NPD (past)
• Jesse Alan Morse, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Miami, FL
  • NPI 1295140085
  NPD (past)
• Joanna Torrens, LMT

  • Physical Medicine & Rehabilitation Physician
  • Miami, FL
  • NPI 1568853380
  NPD (past)
• Mariana Viera-Navarro, PA-C

  • Medical Physician Assistant
  • Miami, FL
  • NPI 1225034861
  NPD (past)
• Michael John Meighen, MD

  • Physical Medicine & Rehabilitation Physician
  • Concord, NC
  • NPI 1255316329
  NPD (past)

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

{
    "created_epoch": "1530748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530748800000",
    "number": "1629564463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 BISCAYNE BLVD STE 406",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331373737",
            "telephone_number": "305-367-1176",
            "fax_number": "877-391-1611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 BISCAYNE BLVD STE 406",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331373737",
            "telephone_number": "305-367-1176",
            "fax_number": "877-391-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSTEOPATHIC REGENERATIVE MEDICINE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-05",
        "last_updated": "2018-07-05",
        "status": "A",
        "authorized_official_last_name": "GODDARD",
        "authorized_official_first_name": "KRISTOPHER",
        "authorized_official_title_or_position": "OWNDER",
        "authorized_official_telephone_number": "305-367-1176",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "FL",
            "license": "OS10979",
            "primary": true
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "FL",
            "license": "OS10979",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": "FL",
            "license": "OS10979",
            "primary": false
        },
        {
            "code": "2083S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Sports Medicine",
            "state": "FL",
            "license": "OS10979",
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "FL",
            "license": "OS10979",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "FL",
            "license": "OS10979",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "FL",
            "license": "OS10979",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "213ER0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Radiology",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Sports Medicine",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paola Catalina Ossa Gomez
• Carolina Alejandra Osses Montoya
• Angie Patricia Ossorio, DO
• Katirina Ost, PA
• Osteopathic Center, LLC
• Osteopathic Rehabilitation Center
• Jacob Corey Oster, MD
• Robin Ostermeier, DC
• Jayleen Ostolaza
• Jennifer Ostolaza

• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Miami, FL
• Providers in Miami, FL by specialty
• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 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.