Organization Active NPI

Regenerative Solutions Sports and Orthopedics, PLLC

  • Orthopaedic Surgery Physician
  • Franklin, TN
National Provider Identifier
1801335096
Registry record updated Feb 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
REGENERATIVE SOLUTIONS SPORTS AND ORTHOPEDICS, PLLC
Practice address
125 Cool Springs Blvd
Suite 240
Franklin, TN 37067-6474
Phone
(901) 484-0837
NPI assigned
Feb 21, 2017
Last updated
Feb 21, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2017

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

Authorized official

Name
Ethan Kellum, MDNPI 1396907705
Title
Owner
Phone
(901) 484-0837

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
Orthopaedic Surgery Physician 207X00000X NU Primary

Addresses

Primary practice location

125 Cool Springs Blvd
Suite 240
Franklin, TN 37067-6474

Mailing address

125 Cool Springs Blvd
Suite 240
Franklin, TN 37067-6474
Phone (901) 484-0837

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170928001891 TN Part B Supplier - Clinic/Group Practice 2062786155 Receives reassigned benefits from 3 practitioners
Practice locations: Franklin, TN

National Provider Directory

National Provider Directory

Locations

125 Cool Springs Blvd
Ste 240
Franklin, TN 37067
Phone (615) 771-6000

Practitioners & affiliated clinicians

Practitioners 3

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": "1487635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487635200000",
    "number": "1801335096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 COOL SPRINGS BLVD",
            "address_2": "SUITE 240",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370676474",
            "telephone_number": "901-484-0837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 COOL SPRINGS BLVD",
            "address_2": "SUITE 240",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370676474",
            "telephone_number": "901-484-0837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENERATIVE SOLUTIONS SPORTS AND ORTHOPEDICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-21",
        "last_updated": "2017-02-21",
        "status": "A",
        "authorized_official_last_name": "KELLUM",
        "authorized_official_first_name": "ETHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-484-0837",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2017; 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.