CENTER FOR REGENERATIVE MEDICINE LLC (NPI# 1760929590) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760929590 |
| Entity Type | Organization |
| Organization Name | CENTER FOR REGENERATIVE MEDICINE LLC |
| Other Organization Name | METAMORPHOSIS CENTER FOR REGENERATIVE MEDICINE |
| Practice Address |
113 Latigo Ln Ste E Canon City CO 81212-8114 |
| Mailing Address |
113 Latigo Ln Canon City CO 81212-8114 |
| Practice Telephone | 7193710000 |
| Practice Fax Number | 8889656893 |
| Mailing Telephone | 7193710000 |
| Mailing Fax Number | 8889656893 |
| Enumeration Date | 2017-01-31 |
| Last Update Date | 2020-03-06 |
| Authorized Official Name | VICTORIA KING (CMO) |
| Authorized Official Telephone | 7193710000 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Metamorphosis Center for Regenerative Medicine | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Center For Regenerative Medicine LLC | 113 Latigo Lane, Suite E, Canyon City, CO 81212 |
| Street Address |
113 LATIGO LN STE E |
| City | CANON CITY |
| State | CO |
| Zip Code | 81212-8114 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083212393 | Buck Jack LLC | Physical Therapist | Mountain View Core Knowledge School 890 Field Ave, Cannon City, CO 81212 | 2020-10-09 |
| 1942841374 | Glorious Works Neurotherapy | Community/Behavioral Health | 115 N 7th Street, Canon City, CO 81212 | 2019-10-07 |
| 1376046292 | Lonnie Mccarron | Social Worker | 600 Evans Rd, Fremont Correctional Facility, Canon City, CO 81212 | 2018-03-16 |
| 1487156964 | Patrick Neil Cox | Case Manager/Care Coordinator | 3239 Independence Road, Canon City, CO 81212 | 2018-03-01 |
| 1831559806 | Justin Ensinger | Counselor | 700 Four Mile Parkway, Canon City, CO 81212 | 2016-03-03 |
| 1710365713 | Amber Conover | Health Educator | 105 N 10th Street, Canon City, CO 81212 | 2015-05-11 |
| 1902073448 | Richard R Williams | Counselor | 612 Field Ave, Canon City, CO 81212 | 2008-05-14 |
| 1861662249 | Huh Inc | Hearing Instrument Specialist | 121 Justice Center Rd Ste D, Canon City, CO 81212 | 2008-03-03 |
| 1013113828 | Deborah Eileen Shock | Nurse Practitioner | 275 W Hwy 50, Canon City, CO 81212 | 2007-06-27 |
| 1245433564 | Lindsey Elizabeth Fish | Internal Medicine | 275 West Hwy 50, Colorado Territorial Correctional Facility, Canon City, CO 81212 | 2007-06-06 |
| Find all providers in zip 81212 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750517561 | Canon City Co Multi Specialty Asc LLC | Clinic/Center | 933 Sells Ave, Canon City, CO 81212-4900 | 2009-06-08 |
| 1255495990 | Arkansas Valley Surgery Center | Clinic/Center | 933 Sells Ave, Suite B, Canon City, CO 81212-4900 | 2006-12-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043819873 | Lone Tree Surgery Center, LLC | Clinic/Center | 9218 Kimmer Dr Ste 101, Lone Tree, CO 80124-6733 | 2020-10-22 |
| 1770180986 | Audubon Ambulatory Surgery Center LLC | Clinic/Center | 6011 E Woodmen Rd Ste 200, Colorado Springs, CO 80923-2604 | 2020-10-01 |
| 1376155440 | Colorado Urologic Surgery Center, LLC | Clinic/Center | 3 Superior Dr Ste 301, Superior, CO 80027-8655 | 2020-08-20 |
| 1548870603 | Durango Surgery Center LLC | Clinic/Center | 1266 Escalante, Suite 101, Durango, CO 81303 | 2020-08-04 |
| 1366064032 | Care Dental Surgical Center of Denver LLC | Clinic/Center | 1111 S Abilene Ct, Aurora, CO 80012-4909 | 2020-05-15 |
| 1790320612 | Gs Campus Asc, LLC | Clinic/Center | Lafayette Surgery Center, 340 Exempla Circle, Suite #400, Lafayette, CO 80026 | 2019-11-14 |
| 1821642661 | Steamboat Surgery Center, LLC | Clinic/Center | 705 Marketplace Plz Ste 150, Steamboat Springs, CO 80487-1800 | 2019-07-30 |
| 1679134795 | Greeley Endoscopy Center, LLC | Clinic/Center | 8227 W 20th St, Greeley, CO 80634-3039 | 2019-06-28 |
| 1912460015 | Premier Eye Surgery Center of Colorado, LLC | Clinic/Center | 1050 W. South Boulder Road, Lafayette, CO 80026 | 2019-04-08 |
| 1659842128 | Milestone Surgical Center LLC | Clinic/Center | 9800 Pyramid Ct Ste 300, Englewood, CO 80112-2667 | 2018-12-10 |
| Find all providers with the same taxonomy | ||||
| City | CANON CITY |
| Zip Code | 81212 |
Please comment or provide details below to improve the information on CENTER FOR REGENERATIVE MEDICINE LLC.
| 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.