REVIVE MEDICAL LLC


Address: 4215 N Classen Blvd Ste 103, Oklahoma City, OK 73118
Phone: 9514401652

REVIVE MEDICAL LLC (NPI# 1528578499) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1528578499
Entity Type Organization
Organization Name REVIVE MEDICAL LLC
Practice Address 4215 N Classen Blvd Ste 103
Oklahoma City
OK 73118
Mailing Address 4215 N Classen Blvd Ste 103
Oklahoma City
OK 73118-2431
Practice Telephone 9514401652
Mailing Telephone 4056737856
Enumeration Date 2017-10-05
Last Update Date 2018-08-22
Authorized Official Name KEVIN BROWN (OWNER)
Authorized Official Telephone 4056737856
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208D00000X General Practice Allopathic & Osteopathic Physicians

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1669087045 Revive Medical LLC Durable Medical Equipment & Medical Supplies 5000, S Scenic, Bolivar, MO 65613 2020-09-11

Other Data Sources

Entity Type Entity Name Entity Address
Colorado Business Entities Revive Medical LLC 5582 Timeless View, Colorado Springs, CO 80915

Office Location

Street Address 4215 N CLASSEN BLVD STE 103
City OKLAHOMA CITY
State OK
Zip Code 73118

Providers in the same location

NPI Name Taxonomy Address Enumeration
1760009229 Mahla Mohsenzadeh Chiropractor 4215 N Classen Blvd Ste 103, Oklahoma City, OK 73118-2426 2020-07-01
1740842327 Revive Health of Oklahoma LLC General Practice 4215 N Classen Blvd Ste 103, Oklahoma City, OK 73118-2426 2019-07-03

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1255812772 Karrie Danea Moreno Behavior Technician 1507 Ne 31st, Oklahoma, OK 73118 2018-08-23
1225556228 Anika Carr Case Manager/Care Coordinator 1212 Nw 32nd Street, Oklahoma City, OK 73118 2017-08-30
1740635168 Nikhil Malhotra Internal Medicine 3635 Vista Avenue At Grand Boulevard, 14th Floor, Desloge Towers, St. Louis, MO 73118 2016-05-04
1144694183 Christopher Woon Counselor 4001 N Classen, Suite 105, Oklahoma City, OK 73118 2015-11-13
1699181925 Stac Embry Counselor 3321 N. Mckinley Ave, Oklahoma City, OK 73118 2014-07-08
1194161216 Jennifer Kaye Powers Counselor 3124 N. Classen Blvd., Ste. A, Oklahoma City, OK 73118 2013-05-15
1932445491 Jessica Camp Behavioral Analyst 3220 N Harvey Pkwy, Oklahoma City, OK 73118 2013-01-02
1942578661 Michael D Danielson Behavioral Analyst 4232 N Sante Fe Ave, Oklahoma City, OK 73118 2011-12-08
1912280587 Tara Roberts Counselor 1743 Nw 37th, Oklahoma City, OK 73118 2011-09-21
1790066769 Jimmy Early Jr. Counselor 4801 Nw Classen, Suite #233, Oklahoma City, OK 73118 2011-09-06
Find all providers in zip 73118

Taxonomy Information

Taxonomy Code 208D00000X
Grouping Allopathic & Osteopathic Physicians
Classification General Practice

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1669080891 Prairie Gardens Medical LLC General Practice 1213 Nw 122nd St Ste 401, Oklahoma City, OK 73114-7000 2020-07-14
1053875781 Oumi Clinics LLC General Practice 1200 Childrens Ave Ste 11200, Oklahoma City, OK 73104-4637 2019-01-28
1891149647 Daniel Enriquez General Practice 1040 7050 S Air Depot Blvd, Oklahoma City, OK 73135 2016-04-18
1669726188 Arrrc, Inc. General Practice 2149 S.w. 59th St., Suite 105, Oklahoma City, OK 73119-7003 2012-11-06
1386932986 George Fred Mcdonnold General Practice 2973 Rolling Stone Rd, Oklahoma City, OK 73120-1921 2011-07-16
1770877151 Michael Shane Johnson General Practice 13600 Prairie View Ln, Oklahoma City, OK 73142-5917 2011-06-03
1295027647 Albert T Nguyen General Practice 2636 Sw 28th St, Oklahoma City, OK 73108-5823 2011-05-04
1538458047 Healthfirst Physician Management General Practice 1111 N Dewey, Pre-op Clinic, Oklahoma City, OK 73103 2011-04-05
1114154960 Joshua Alan Stevens General Practice 301 Nw 6th St, Ste 150, Oklahoma City, OK 73102-2823 2009-06-19
1629226717 Family Medical Office, LLC General Practice 9220 S Penn Ave, Suite A, Oklahoma City, OK 73159-6937 2008-09-03
Find all providers in OKLAHOMA CITY

Competitor

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City OKLAHOMA CITY
Zip Code 73118

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Dataset Information

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.

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