REGENERATIVE THERAPY OF GEORGIA, LLC (NPI# 1962973156) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962973156 |
| Entity Type | Organization |
| Organization Name | REGENERATIVE THERAPY OF GEORGIA, LLC |
| Practice Address |
875 Old Roswell Rd Ste F100 Roswell GA 30076-1658 |
| Mailing Address |
5132 Panola Mill Dr Lithonia GA 30038-2351 |
| Practice Telephone | 7703806560 |
| Mailing Telephone | 7709061316 |
| Enumeration Date | 2018-12-16 |
| Last Update Date | 2018-12-16 |
| Authorized Official Name | MRS. LAKENDRA FULBRIGHT (OWNER) |
| Authorized Official Telephone | 7709061316 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
Ambulatory Health Care Facilities |
| Street Address |
875 OLD ROSWELL RD STE F100 |
| City | ROSWELL |
| State | GA |
| Zip Code | 30076-1658 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033623673 | Body G O A L S Physical Therapy & Wellness | Clinic/Center | 875 Old Roswell Rd Ste F100, Roswell, GA 30076-1658 | 2017-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275505 | Apex Spine and Neurosurgery LLC | Neurological Surgery | 1295 Hembree Rd Ste 200 Bldg B, Roswell, GA 30076 | 2020-11-06 |
| 1841776689 | Scott Gunter Brunson | Hearing Instrument Specialist | 777 Old Roswell Pl # E100, Roswell, GA 30076 | 2018-07-16 |
| 1861998197 | Daniel B Charek | Clinical Neuropsychologist | 11685 Alpharetta Hwy Ste 170, Roswell, GA 30076 | 2018-04-04 |
| 1427575554 | A One Home Care, Inc. | In Home Supportive Care | 1875 Old Alabama Road, Suite 420, Roswell, GA 30076 | 2017-08-29 |
| 1053836023 | Madelon Morgan | Counselor | 555 Sun Valley Dr Bldg F, Roswell, GA 30076 | 2017-08-10 |
| 1245769637 | Family Behavioral Health, LLC | Clinic/Center | 9275 Martin Rd, Roswell, GA 30076 | 2017-06-08 |
| 1093163750 | Ryann Soutar | Counselor | 702 Macy Dr, Roswell, GA 30076 | 2016-06-02 |
| 1447618707 | Concierge Medical Mgmt Group | Contractor | 760 Old Roswell Rd Ste 117, Roswell, GA 30076 | 2016-02-02 |
| 1063877710 | Augustine Young | Community/Behavioral Health | 427 Royal Creek Dr, Roswell, GA 30076 | 2015-12-23 |
| 1710360441 | Currents Massage LLC | Massage Therapist | 760 Old Roswell Road, Suite 230, Roswell, GA 30076 | 2015-06-30 |
| Find all providers in zip 30076 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
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|---|---|---|---|---|
| 1770122277 | Mind & Body Healthcare LLC | Clinic/Center | 1700 N Union Ave, Roswell, NM 88201-3267 | 2019-12-31 |
| 1407328776 | Activate Your Health Nutrition, LLC | Clinic/Center | 1905 Woodstock Rd Ste 7100, Roswell, GA 30075-5632 | 2018-12-26 |
| 1073952123 | Whole Body Medical LLC | Clinic/Center | 500 Sun Valley Dr, Ste. A-2, Roswell, GA 30076-1482 | 2013-06-21 |
| 1588943070 | Gkm Healthcare Solutions, LLC | Clinic/Center | 1150 Grimes Bridge Rd, Suite 400, Roswell, GA 30075-3988 | 2011-08-15 |
| 1427336098 | Roswell Family Chiropractic and Wellness Pa | Clinic/Center | 100 E Linda Vista Blvd, Roswell, NM 88201-6654 | 2011-07-29 |
| 1811219876 | Complete Medical Services LLC | Clinic/Center | 109 W Bland St, Roswell, NM 88203-5708 | 2010-02-18 |
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| 1467068361 | Rc Chiropractic & Personal Injury Centers LLC | Clinic/Center | 3547 Peachtree Industrial Blvd Ste 10, Duluth, GA 30096-1419 | 2020-09-17 |
| 1467066639 | Luminous Care, LLC | Clinic/Center | 285 Boulevard Ne Ste 145, Atlanta, GA 30312-4204 | 2020-09-03 |
| 1558974709 | Medlife Healthcare | Clinic/Center | 2129 Friendship Rd, Flowery Branch, GA 30542 | 2020-08-27 |
| 1679181168 | Guardian Health Group | Clinic/Center | 6296 Cheatham Lake Dr Nw, Acworth, GA 30101-7642 | 2020-07-21 |
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| 1487271342 | Temak Telehealth | Clinic/Center | 635 Granville Ct, Atlanta, GA 30328-3445 | 2020-06-26 |
| 1992321301 | Hope Harbor Wellness LLC | Clinic/Center | 126 Enterprise Path Ste 208, Hiram, GA 30141-2654 | 2020-06-22 |
| 1447875307 | Georgia Palliative Services, LLC | Clinic/Center | 3660 Cedarcrest Rd Ste 120, Acworth, GA 30101-8928 | 2020-06-16 |
| 1548884000 | 2 Wolves Inc | Clinic/Center | 783 S Main St Ste 5, Cleveland, GA 30528-4519 | 2020-06-01 |
| 1245860816 | The Wellness Sanctuary, Inc | Clinic/Center | 206 Rogers St Ne Apt 117, Atlanta, GA 30317-1035 | 2020-01-22 |
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| 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.