| Exodus Regenerative Medicine Llc | |
|
104 Eastpark Dr Ste 102 Brentwood TN 37027-7535 | |
| (615) 445-7701 | |
| (615) 445-7771 |
| Full Name | Exodus Regenerative Medicine Llc |
|---|---|
| Speciality | Chiropractor |
| Location | 104 Eastpark Dr Ste 102, Brentwood, Tennessee |
| Authorized Official Name and Position | Justin Kyle Ard (OWNER) |
| Authorized Official Contact | 6154457701 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Exodus Regenerative Medicine Llc 104 Eastpark Dr Ste 102 Brentwood TN 37027-7535 Ph: (615) 445-7701 | Exodus Regenerative Medicine Llc 104 Eastpark Dr Ste 102 Brentwood TN 37027-7535 Ph: (615) 445-7701 |
| NPI Number | 1093284671 |
|---|---|
| Provider Enumeration Date | 11/13/2018 |
| Last Update Date | 11/30/2025 |
| Medicare PECOS PAC ID | 7214348556 |
|---|---|
| Medicare Enrollment ID | O20201118000392 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093284671 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| Provider Name | Millard D Collins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952389173 PECOS PAC ID: 5395710495 Enrollment ID: I20040901000365 |
| Provider Name | Justin Kyle Ard |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1366758716 PECOS PAC ID: 3870762990 Enrollment ID: I20110808000120 |
| Provider Name | Gary K Adams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487772802 PECOS PAC ID: 9638270390 Enrollment ID: I20190827000287 |
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