Active NPI
Revive Health LLC
- Psychiatric/Mental Health Clinical Nurse Specialist
- Laurel, MD
National Provider Identifier
1003530502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Clinical Nurse Specialist
- Legal business name
- REVIVE HEALTH LLC
- Practice address
- 13715 Oaklands Manor Dr
Laurel, MD 20708-1430 - Phone
- (443) 945-8482
- NPI assigned
- Sep 28, 2022
- Last updated
- Sep 28, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Maria Tancho, CRNP
- Title
- Ceo
- Phone
- (443) 945-8482
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Clinical Nurse Specialist | 364SP0808X | Primary |
Addresses
Primary practice location
13715 Oaklands Manor Dr
Laurel, MD 20708-1430
Mailing address
13715 Oaklands Manor Dr
Laurel, MD 20708-1430
Phone (443) 945-8482
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Psychiatric/Mental Health Nurse Practitioner
- Laurel, MD
- NPI 1316404353
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664323200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1664323200000",
"number": "1003530502",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13715 OAKLANDS MANOR DR",
"city": "LAUREL",
"state": "MD",
"postal_code": "207081430",
"telephone_number": "443-945-8482"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13715 OAKLANDS MANOR DR",
"city": "LAUREL",
"state": "MD",
"postal_code": "207081430",
"telephone_number": "443-945-8482"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "REVIVE HEALTH LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-09-28",
"last_updated": "2022-09-28",
"certification_date": "2022-09-28",
"status": "A",
"authorized_official_last_name": "TANCHO",
"authorized_official_first_name": "MARIA",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "443-945-8482",
"authorized_official_credential": "CRNP"
},
"taxonomies": [
{
"code": "364SP0808X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Laurel, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.