Regenerative Therapy of Georgia

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

REGENERATIVE THERAPY OF GEORGIA

Practice address

5040 Snapfinger Woods Drive
Suite 200
Stonecrest, GA 30035

Phone

(770) 380-6560

Fax

(770) 502-6745

NPI assigned

Dec 16, 2018

Last updated

Sep 22, 2022By 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

Mrs. Lakendra FulbrightNPI 1740585181

Title

Owner

Phone

(770) 906-1316

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

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.

• Lakendra S Fulbright, D.C

  • Chiropractor
  • Lithonia, GA
  • NPI 1740585181
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663804800000",
    "number": "1962973156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5132 PANOLA MILL DR",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300382351",
            "telephone_number": "770-906-1316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5040 SNAPFINGER WOODS DRIVE",
            "address_2": "SUITE 200",
            "city": "STONECREST",
            "state": "GA",
            "postal_code": "30035",
            "telephone_number": "770-380-6560",
            "fax_number": "770-502-6745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENERATIVE THERAPY OF GEORGIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-16",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A",
        "authorized_official_last_name": "FULBRIGHT",
        "authorized_official_first_name": "LAKENDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-906-1316",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mercy Oyerinde, NP
• Priyanka Pandya, PT
• Pro-Fit Rehab and Sports Medicine (Advanced Physical Therapy and Sports Medicine)
• Quality Care Pediatrics, LLC
• Darcell Rasmussen, LCSW
• Sacred 7 Enterprises, LLC
• Naleisha-Ann Kealohilani Satele
• Antonio Jahron Saunders
• Annie R Slayton
• Kadijah S Smith, DDS

• Health Service Clinic/Center in Stonecrest, GA
• Providers in Stonecrest, GA by specialty
• Health Service Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; 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.