REGENERATIVE MEDICAL GROUP INC (NPI# 1821557281) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821557281 |
| Entity Type | Organization |
| Organization Name | REGENERATIVE MEDICAL GROUP INC |
| Practice Address |
2005 N 2nd St Booneville MS 38829-7728 |
| Mailing Address |
615 E Chapman Ave Orange CA 92866-1643 |
| Practice Telephone | 6624163306 |
| Enumeration Date | 2019-03-15 |
| Last Update Date | 2019-03-15 |
| Authorized Official Name | BRYN JARALD HENDERSON (OWNER) |
| Authorized Official Telephone | 7146394012 |
| Is Organization Subpart | Y |
| Parent Organization Name | REGENERATIVE MEDICAL GROUP INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Regenerative Medical Group | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548732159 | Regenerative Medical Group Inc | Family Medicine | 2624 S, Us1, Fort Pierce, FL 34982 | 2018-12-20 |
| 1366051419 | Regenerative Medical Group Inc | Family Medicine | 54910, Pine Crest Avenue, Idyllwild, CA 92549 | 2020-07-24 |
| 1801368345 | Regenerative Medical Group Inc | Internal Medicine | 11415 Slater Ave Ne Ste 102, Kirkland, WA 98033-4656 | 2018-12-21 |
| 1659843274 | Regenerative Medical Group Inc | Family Medicine | 711 E Chapman Ave, Orange, CA 92866-1620 | 2018-12-20 |
| 1013328277 | Regenerative Medical Group Inc | Family Medicine | 615 E Chapman Ave, Orange, CA 92866-1643 | 2014-05-09 |
| Street Address |
2005 N 2ND ST |
| City | BOONEVILLE |
| State | MS |
| Zip Code | 38829-7728 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962029249 | Ortho Express Holding Company, LLC | Clinic/Center | 608 W Church St, Booneville, MS 38829 | 2020-07-02 |
| 1073142600 | Chelsea Cara Mcmillin | Registered Nurse | 2014 C East Chambers Drive, Booneville, MS 38829 | 2020-04-06 |
| 1396210274 | Hooper Transportation LLC | Private Vehicle | 105 Jacinto Heights, No 2, Booneville, MS 38829 | 2018-10-08 |
| 1699251314 | John L Hooper | Driver | 105 Jacinto Heights No 2, Booneville, MS 38829 | 2018-07-16 |
| 1750744389 | Jeni Ramey | Social Worker | 214 Dogwood Estates, Booneville, MS 38829 | 2016-03-31 |
| 1770944977 | Judy Dillard | Peer Specialist | 2100 Chambers Drive, Booneville, MS 38829 | 2016-03-15 |
| 1508253295 | Mary Grace Hancock | Internal Medicine | 202 N 1st St Ste B, Booneville, MS 38829 | 2015-04-20 |
| 1508042722 | Mary Dean Stone | Registered Nurse | 2100 East Chamberss, Booneville, MS 38829 | 2008-01-17 |
| 1144406430 | Amy Cole | Registered Nurse | 2100 East Chambers, Booneville, MS 38829 | 2008-01-16 |
| 1972715118 | Rita D. Jones | Nurse Practitioner | 1907 South Lake Street, Booneville, MS 38829 | 2007-05-03 |
| Find all providers in zip 38829 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245633692 | Cooper Clinic Pa | Family Medicine | 690 N Kennedy Ave Rm 1, Booneville, AR 72927-3240 | 2014-09-30 |
| 1447461900 | South Logan Family Practice | Family Medicine | 1808 East Main, Booneville, AR 72927-1373 | 2007-05-25 |
| 1326152109 | Family Practice Clinic of Booneville, Inc. | Family Medicine | 200 Mulberry St, Suite A, Booneville, KY 41314-7505 | 2006-08-18 |
| 1043257827 | Mountain Comprehensive Health Corporation | Family Medicine | 826 Ky 11 N, Booneville, KY 41314-9155 | 2006-06-01 |
| 1124090618 | Erik Ward Dukes | Family Medicine | 1301 N 2nd St, Booneville, MS 38829-1028 | 2006-02-07 |
| 1588664510 | Clifton C Cartwright | Family Medicine | 517 E Church St, Booneville, MS 38829-3709 | 2005-08-01 |
| 1922006790 | Booneville Family Clinic | Family Medicine | 128 Daniel Ave, Booneville, AR 72927-0110 | 2005-07-14 |
| 1598323511 | Lauren Waters | Family Medicine | 618 County Road 5031, Booneville, MS 38829-9410 | 2019-06-04 |
| 1558716738 | William Andrew Stevenson Iv | Family Medicine | 128 Daniel Dr, Booneville, AR 72927-4055 | 2016-04-26 |
| 1871900795 | Brittany Bobrowski | Family Medicine | 826 Ky 11 N, Booneville, KY 41314-9469 | 2014-07-14 |
| Find all providers in BOONEVILLE | ||||
| City | BOONEVILLE |
| Zip Code | 38829 |
Please comment or provide details below to improve the information on REGENERATIVE MEDICAL GROUP INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.