Regeneration Orthopedics, LLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

REGENERATION ORTHOPEDICS, LLC

Practice address

3986 Maryville Rd
Granite City, IL 62040-4191

Phone

(636) 536-7000

Fax

(636) 898-5709

NPI assigned

Oct 29, 2012

Last updated

Oct 29, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Karen Wilson

Title

Office Manager

Phone

(636) 536-7000

Specialties & licenses 2

Addresses

Tax ID family

Regeneration Orthopedics LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Regeneration Orthopedics, LLC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Ballwin, MO
  • NPI 1720332893
  NPD tax ID
• Regeneration Orthopedics, LLC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Saint Louis, MO
  • NPI 1891049979
  NPD tax ID

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

{
    "created_epoch": "1351468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351468800000",
    "number": "1649524711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 MCBRIDE AND SON CENTER DR",
            "address_2": "STE 204",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051418",
            "telephone_number": "636-536-7000",
            "fax_number": "636-898-5709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3986 MARYVILLE RD",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620404191",
            "telephone_number": "636-536-7000",
            "fax_number": "636-898-5709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENERATION ORTHOPEDICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-29",
        "last_updated": "2012-10-29",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "636-536-7000"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debabrata Ray, MD
• Jessica Dawn Ray, D.C
• Kasey Jo Reader
• Blake Reed, D.C.
• Ruth Reeves
• Regenerative Health and Chiropractic, LTD
• Renal Treatment Centers-Illinois Inc (Granite City Dialysis Center)
• Residential Options
• Residential Options, Inc.
• Kyle David Rice, PHARM D.

• Pain Medicine (Anesthesiology) Physician in Granite City, IL
• Providers in Granite City, IL by specialty
• Pain Medicine (Anesthesiology) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2012; 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.