Organization Active NPI

Regen Pain Management, PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Plano, TX
National Provider Identifier
1699122101
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
Q0953 Issued in TX
Legal business name
REGEN PAIN MANAGEMENT, PLLC
Practice address
6020 W Parker Rd Ste 300
Plano, TX 75093-8177
Phone
(469) 252-4777
Fax
(469) 518-2156
NPI assigned
May 16, 2016
Last updated
Mar 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Authorized official

Name
Dr. Jonathan C Koning, MDNPI 1710216841
Title
President
Phone
(469) 252-4777

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X Q0953 TX Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

6020 W Parker Rd Ste 300
Plano, TX 75093-8177

Mailing address

6020 W Parker Rd Ste 300
Plano, TX 75093-8177
Phone (469) 252-4777

Other practice location 1

11500 Hwy 121 Bldg 400
suite 420
Frisco, TX 75035
Phone (469) 252-4777

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160622000992 TX Part B Supplier - Clinic/Group Practice 5496046468 Receives reassigned benefits from 2 practitioners
Practice locations: Frisco, TX; Plano, TX

National Provider Directory

National Provider Directory

Locations

3575 Victory Group Way
Ste 100
Frisco, TX 75034

5550 Warren Pkwy
Ste 110
Frisco, TX 75034
Phone (214) 440-1245

200 N Carrier Pkwy
Grand Prairie, TX 75050
Phone (214) 664-5933

Practitioners & affiliated clinicians

Practitioners 2

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": "1463356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711497600000",
    "number": "1699122101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6020 W PARKER RD STE 300",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750938177",
            "telephone_number": "469-252-4777",
            "fax_number": "469-518-2156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6020 W PARKER RD STE 300",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750938177",
            "telephone_number": "469-252-4777",
            "fax_number": "469-518-2156"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11500 Hwy 121 Bldg 400",
            "address_2": "suite 420",
            "address_purpose": "LOCATION",
            "city": "Frisco",
            "state": "TX",
            "postal_code": "75035",
            "country_code": "US",
            "telephone_number": "469-252-4777",
            "fax_number": "469-518-2156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REGEN PAIN MANAGEMENT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-16",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-25",
        "status": "A",
        "authorized_official_last_name": "KONING",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "469-252-4777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "TX",
            "license": "Q0953",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; 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.