MD Regeneration, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

5101020789 Issued in MI

Legal business name

MD REGENERATION, PLLC

Practice address

333 W 7TH St Ste 100
Royal Oak, MI 48067-2510

Phone

(248) 561-0602

NPI assigned

Feb 12, 2018

Organization subpart

No

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

Authorized official

Name

Mackenzie Jennings

Title

Credentialing Specialist

Phone

(617) 454-4916

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1518393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566518400000",
    "number": "1780183186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41000 WOODWARD AVE STE 350",
            "city": "BLOOMFIELD",
            "state": "MI",
            "postal_code": "483045092",
            "telephone_number": "248-404-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 W 7TH ST STE 100",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480672510",
            "telephone_number": "248-561-0602"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "37300 Dequindre Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Sterling Heights",
            "state": "MI",
            "postal_code": "483103597",
            "country_code": "US",
            "telephone_number": "248-561-0602",
            "fax_number": "586-275-0066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MD REGENERATION, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-12",
        "last_updated": "2019-08-23",
        "status": "A",
        "authorized_official_last_name": "JENNINGS",
        "authorized_official_first_name": "MACKENZIE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "617-454-4916"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101020789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica McMurtry, LMSW-CLINICAL
• Katherine Audrey McNally, MD
• Ryan McNassor, MD
• Judy Lynn McRobb, NCTMB CERTIFIED
• MD Lee Counseling, PLLC
• Meaningful Psychotherapy LLC
• Medical Service Company
• Medilodge of Royal Oak
• Medivan LLC
• James Lawrence Meek, P.T.

• Internal Medicine Physician in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2019; 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.