NPIMap

Organization Active NPI

Joint Regeneration and Anti-Aging of Newnan

  • Pain Medicine Physician
  • Newnan, GA
National Provider Identifier
1770127615
Registry record updated Apr 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
JOINT REGENERATION AND ANTI-AGING OF NEWNAN
Practice address
51 Hospital Rd
Newnan, GA 30263-1209
Phone
(770) 251-5544
NPI assigned
Nov 4, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2020

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

Authorized official

Name
Krystin Manzi
Title
MBR
Phone
(410) 507-5333

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Management Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WP0000X
Wound Care Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WW0000X
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

51 Hospital Rd
Newnan, GA 30263-1209

Mailing address

51 Hospital Rd
Newnan, GA 30263-1209
Phone (770) 251-5544

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL practiceehr.com Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1572825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587772800000",
    "number": "1770127615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 HOSPITAL RD",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302631209",
            "telephone_number": "770-251-5544",
            "fax_number": "855-552-3776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 HOSPITAL RD",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302631209",
            "telephone_number": "770-251-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOINT REGENERATION AND ANTI-AGING OF NEWNAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-04",
        "last_updated": "2020-04-25",
        "certification_date": "2020-04-25",
        "status": "A",
        "authorized_official_last_name": "MANZI",
        "authorized_official_first_name": "KRYSTIN",
        "authorized_official_title_or_position": "MBR",
        "authorized_official_telephone_number": "410-507-5333"
    },
    "taxonomies": [
        {
            "code": "163WP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Pain Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Wound Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "practiceehr.com",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "unknown",
            "address_1": "51 Hospital Rd",
            "city": "Newnan",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302631209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.