REVELATION ENTERPRISES INC (NPI# 1740366210) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740366210 |
| Entity Type | Organization |
| Organization Name | REVELATION ENTERPRISES INC |
| Other Organization Name | REV PRO INC PROSTHETICS & ORTHOTICS |
| Practice Address |
2122 W Reno Ave Oklahoma City OK 73107-7028 |
| Practice Telephone | 4053190685 |
| Practice Fax Number | 4053190684 |
| Mailing Telephone | 4053190685 |
| Mailing Fax Number | 4053190684 |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. ANITA C MULLIN (VICE PRESIDENT) |
| Authorized Official Telephone | 4053190685 |
| Authorized Official Credential | CMF |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | 39 | OK | Suppliers |
| Other Name | Type Code |
|---|---|
| Rev Pro Inc Prosthetics & Orthotics | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | REVELATION ENTERPRISES INC. | 19 Ruxton Road, Apt 1, Mattapan, MA 02126 |
| Street Address |
2122 W RENO AVE |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73107-7028 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144747999 | Ellen Rose Pochyly | Counselor | 2617 General Pershing Boulevard, Oklahoma City, OK 73107 | 2017-08-23 |
| 1609399906 | Carrie Ann Moore | Counselor | 2617 General Pershing Blvd., Oklahoma City, OK 73107 | 2017-07-19 |
| 1821511320 | Diana Lynn Spencer | Counselor | 2617generalpershingblvd, Oklahoma City, OK 73107 | 2017-07-18 |
| 1861859514 | Catherine Evans | Counselor | 500 N Meridian Ave Ste 409, Oklahoma City, OK 73107 | 2016-01-26 |
| 1871964551 | Kizzy Frazier | Student in an Organized Health Care Education/Training Program | 1233 N Warren Pl, Oklahoma City, OK 73107 | 2015-10-07 |
| 1538550629 | Oklahoma Department of Mental Health and Substance Abuse | Case Management | 2625 General Pershing Boulevard, Oklahoma City, OK 73107 | 2015-02-10 |
| 1952702276 | Andale Healthcare, LLC | Clinic/Center | 2305 N. Meridian, Oklahoma City, OK 73107 | 2014-09-05 |
| 1114339348 | John Walls | Psychologist | 2012 North Villa Avenue, Oklahoma City, OK 73107 | 2014-05-22 |
| 1376970517 | Latrice Warrior | Community/Behavioral Health | 2625 General Pershing Drive, Oklahoma City, OK 73107 | 2013-10-02 |
| 1326485541 | Debra Sue Vaughan | Counselor | 2617 Genral Pershing Blvd, Oklahoma City, OK 73107 | 2013-05-29 |
| Find all providers in zip 73107 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619515541 | Lamoor Beauty Supply | Prosthetic/Orthotic Supplier | 2214 N Martin Luther King Ave, Oklahoma City, OK 73111-2404 | 2019-12-10 |
| 1598258378 | Otto Bock Orthopedic Services LLC | Prosthetic/Orthotic Supplier | 5601 Nw 72nd Street, Suite 257, Oklahoma City, OK 73132-5920 | 2018-06-07 |
| 1639577885 | La Fuente Prosthetics | Prosthetic/Orthotic Supplier | 229 N.w. 9th Street, Oklahoma City, OK 73102 | 2014-12-19 |
| 1881937977 | Celerity Prosthetics, LLC | Prosthetic/Orthotic Supplier | 8625 S Walker Ave, Oklahoma City, OK 73139-9462 | 2013-03-27 |
| 1427376193 | Genuine Care Rehabilitation Service Inc. | Prosthetic/Orthotic Supplier | 7510 Broadway Ext, Suite 204, Oklahoma City, OK 73116-9031 | 2010-05-05 |
| 1942490784 | Hi Fashion Wigs LLC | Prosthetic/Orthotic Supplier | 1133 North May Ave. Ss, Oklahoma City, OK 73107-5335 | 2007-07-27 |
| 1164551479 | Hair2wear, LLC | Prosthetic/Orthotic Supplier | 11624 Willow Way, Oklahoma City, OK 73162-2046 | 2007-03-04 |
| 1124075833 | Scott Sabolich Prosthetic & Research LLC | Prosthetic/Orthotic Supplier | 10201 Broadway Ext, Oklahoma City, OK 73114-6217 | 2006-05-28 |
| 1881672707 | Compton Shoe Inc | Prosthetic/Orthotic Supplier | 3703 Nw 50th St, Oklahoma City, OK 73112-2553 | 2006-01-03 |
| 1679568125 | Tim Carlton Prosthetics Inc. | Prosthetic/Orthotic Supplier | 9414 Westgate Rd, Suite B., Oklahoma City, OK 73162-6245 | 2005-09-12 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73107 |
Please comment or provide details below to improve the information on REVELATION ENTERPRISES INC.
| 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.