NPI Code Detail JSON Logo

1376116343 NPI number — ATLANTIC KNEE RESTORATION & REGENERATIVE MEDICINE - RESTON

NPI Number: 1376116343
Health Care Provider/Practitioner: ATLANTIC KNEE RESTORATION & REGENERATIVE MEDICINE - RESTON

Information about “1376116343” NPI (ATLANTIC KNEE RESTORATION & REGENERATIVE MEDICINE - RESTON) exists in 1376116343 in HTML format HTML  |  1376116343 in plain Text format TXT  |  1376116343 in PDF (Portable Document Format) PDF  |  1376116343 in an XML format XML  formats.

NPI Number : 1376116343 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1376116343",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ATLANTIC KNEE RESTORATION & REGENERATIVE MEDICINE - RESTON",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "7481 RIGHT FLANK RD STE 100",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MECHANICSVILLE",
    "MailingAddressStateName": "VA",
    "MailingAddressPostalCode": "23116-3838",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "804-877-0100",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "106 ELDEN ST STE 10",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HERNDON",
    "PracticeLocationAddressStateName": "VA",
    "PracticeLocationAddressPostalCode": "20170-4826",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "703-854-1432",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/19/2021",
    "LastUpdateDate": "09/28/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "CRITTENDEN",
    "AuthorizedOfficialFirstName": "ROBERT",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": "III",
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "256-302-2228",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207R00000X",
          "TaxonomyName": "Internal Medicine Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2081P2900X",
          "TaxonomyName": "Pain Medicine (Physical Medicine & Rehabilitation) Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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