Infinite Regenerative Medical Group, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

INFINITE REGENERATIVE MEDICAL GROUP, INC.

Practice address

3565 S Higuera St
San Luis Obispo, CA 93401-7339

Phone

(805) 548-8877

Fax

(805) 548-0055

NPI assigned

Jan 31, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Jon Wells, DCNPI 1831249945

Title

Secretary

Phone

(805) 548-8877

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jon Paul Wells, D.C.

  • Chiropractor
  • Atascadero, CA
  • NPI 1831249945
  NPD Authorized official

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

{
    "created_epoch": "1548892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593648000000",
    "number": "1992269294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3565 S HIGUERA ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934017339",
            "telephone_number": "805-548-8877",
            "fax_number": "805-548-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3565 S HIGUERA ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934017339",
            "telephone_number": "805-548-8877",
            "fax_number": "805-548-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFINITE REGENERATIVE MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-31",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "805-548-8877",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1831249945",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1992783302",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC",
            "identifier": "DC20839",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC",
            "identifier": "G58508",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.