Advanced Regenerative Healthcare and Physical Medicine of Brunswick

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

ADVANCED REGENERATIVE HEALTHCARE AND PHYSICAL MEDICINE OF BRUNSWICK

Practice address

712 Mall Blvd
Brunswick, GA 31525-0539

Phone

(912) 262-9735

Fax

(912) 262-9634

NPI assigned

Jun 7, 2017

Last updated

Jul 21, 2022By 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

Renfred R. Halverson, DC, PC

Title

Owner

Phone

(912) 262-9735

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1496793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1649709262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 MALL BLVD",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315250539",
            "telephone_number": "912-262-9735",
            "fax_number": "912-262-9634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 MALL BLVD",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315250539",
            "telephone_number": "912-262-9735",
            "fax_number": "912-262-9634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED REGENERATIVE HEALTHCARE AND PHYSICAL MEDICINE OF BRUNSWICK",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-07",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HALVERSON",
        "authorized_official_first_name": "RENFRED",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-262-9735",
        "authorized_official_credential": "DC, PC"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Brunswick, GA
• Providers in Brunswick, GA by specialty
• Multi-Specialty Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.