Indiana Regenerative Medicine Institute LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

INDIANA REGENERATIVE MEDICINE INSTITUTE LLC

Practice address

8202 Clearvista Pkwy Ste 9D
Indianapolis, IN 46256-1457

Phone

(317) 653-4503

NPI assigned

Jun 18, 2019

Last updated

Apr 22, 2020By 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

Preston Peachee, DC

Title

Tin Owner

Phone

(317) 653-4503

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587513600000",
    "number": "1699335042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8202 CLEARVISTA PKWY STE 9D",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561457",
            "telephone_number": "317-578-7544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8202 CLEARVISTA PKWY STE 9D",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561457",
            "telephone_number": "317-653-4503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA REGENERATIVE MEDICINE INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-18",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A",
        "authorized_official_last_name": "PEACHEE",
        "authorized_official_first_name": "PRESTON",
        "authorized_official_title_or_position": "TIN OWNER",
        "authorized_official_telephone_number": "317-653-4503",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Multi-Specialty Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2020; 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.