NPIMap

Organization Active NPI

Regenerative Medical Group Inc

  • Family Medicine Physician
  • Orange, CA
National Provider Identifier
1659843274
Registry record updated Dec 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
REGENERATIVE MEDICAL GROUP INC
Practice address
711 E Chapman Ave
Orange, CA 92866-1620
Phone
(714) 605-8699
NPI assigned
Dec 20, 2018
Organization subpart
Yes
Parent organization
REGENERATIVE MEDICAL GROUP INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 20, 2018

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

Authorized official

Name
Bryn Jarald Henderson, DONPI 1447296694
Title
Owner
Phone
(714) 639-4012

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

711 E Chapman Ave
Orange, CA 92866-1620

Mailing address

615 E Chapman Ave
Orange, CA 92866-1643
Phone (714) 639-4012

National Provider Directory

National Provider Directory
Tax ID family
Regenerative Medical Group7 organizations share this tax ID, including this one
Part of
Regenerative Medical Group

Other organizations with this tax ID 6

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

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1545264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545264000000",
    "number": "1659843274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 E CHAPMAN AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928661643",
            "telephone_number": "714-639-4012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 E CHAPMAN AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928661620",
            "telephone_number": "714-605-8699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENERATIVE MEDICAL GROUP INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "REGENERATIVE MEDICAL GROUP INC",
        "enumeration_date": "2018-12-20",
        "last_updated": "2018-12-20",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "BRYN",
        "authorized_official_middle_name": "JARALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-639-4012",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.