Revelation Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6674 Issued in CO

Legal business name

REVELATION CHIROPRACTIC LLC

Practice address

2721 S College Ave Unit 4a
Fort Collins, CO 80525-2160

Phone

(970) 377-2250

Fax

(970) 377-2251

NPI assigned

Sep 20, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Chad McMahan, D.C.NPI 1689962391

Title

Owner

Phone

(970) 377-2250

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chad McMahan, D.C.

  • Chiropractor
  • Fort Collins, CO
  • NPI 1689962391
  Medicare reassignment NPD Authorized official
• Preston Roy Yurt, DC

  • Chiropractor
  • Fort Collins, CO
  • NPI 1073445888
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1316476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316476800000",
    "number": "1003199779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2721 S COLLEGE AVE UNIT 4A",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805252160",
            "telephone_number": "970-377-2250",
            "fax_number": "970-377-2251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2721 S COLLEGE AVE UNIT 4A",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805252160",
            "telephone_number": "970-377-2250",
            "fax_number": "970-377-2251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVELATION CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-20",
        "last_updated": "2011-09-20",
        "status": "A",
        "authorized_official_last_name": "MCMAHAN",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-377-2250",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "6674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Chiropractor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.