Spine and Sports Regenerative Medicine Institute
NPI 1114764107 · Interventional Pain Medicine Physician · Fairfax, VA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Spine and Sports Regenerative Medicine Institute is a Interventional Pain Medicine Physician organization in Fairfax, VA (NPI 1114764107).
Provider details
- NPI number
- 1114764107
- Entity type
- Organization
- Primary specialty
- Interventional Pain Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- David Kim, Ceo(703) 349-4205
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Pain Medicine Physician208VP0000X
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Spine and Pain Regenerative Medicine
- Doing business as
- Spine and Pain Regenerative Medicine
Registry dates
- Enumerated
- 2024-07-09
- Last updated
- 2024-07-16
- Certified
- 2024-07-16
Frequently asked questions
- What is Spine and Sports Regenerative Medicine Institute's NPI number?
- Spine and Sports Regenerative Medicine Institute's National Provider Identifier (NPI) is 1114764107, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Spine and Sports Regenerative Medicine Institute?
- Spine and Sports Regenerative Medicine Institute is classified in the NPPES registry as Interventional Pain Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Spine and Sports Regenerative Medicine Institute located?
- Spine and Sports Regenerative Medicine Institute's practice location on file with NPPES is 10721 Main St Ste 304, Fairfax, VA 22030-6902.
- What is Spine and Sports Regenerative Medicine Institute's phone number?
- The practice phone number listed in the NPPES registry for Spine and Sports Regenerative Medicine Institute is (703) 349-4205.
- Does Spine and Sports Regenerative Medicine Institute accept Medicare?
- Spine and Sports Regenerative Medicine Institute is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Spine and Sports Regenerative Medicine Institute?
- The authorized official listed on Spine and Sports Regenerative Medicine Institute's NPPES record is David Kim, Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Spine and Sports Regenerative Medicine Institute's NPI active?
- Yes — Spine and Sports Regenerative Medicine Institute's NPI (1114764107) is active in the NPPES registry as of the last update on 2024-07-16.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.