Revolutionary Care LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

REVOLUTIONARY CARE LLC

Practice address

106 Irving St NW Ste 3000
Washington, DC 20010-2969

Phone

(240) 421-3602

NPI assigned

Aug 24, 2022

Organization subpart

No

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

Authorized official

Name

Titilayo Orimogunje

Title

President

Phone

(240) 421-3602

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661299200000",
    "number": "1033838941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14311 DRIFTWOOD RD",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207213042",
            "telephone_number": "240-421-3602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 IRVING ST NW STE 3000",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102969",
            "telephone_number": "240-421-3602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVOLUTIONARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-24",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A",
        "authorized_official_last_name": "ORIMOGUNJE",
        "authorized_official_first_name": "TITILAYO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "240-421-3602"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Ellen V Revenis, MD
• Revital Health Care Services LLC
• Thomas Jacob Revitte, PHARMD
• Revive Clinic LLC
• Revolution Medicine Health & Fitness PLLC
• Olga Evgenyevna Revzina
• Rex H. Hoang, DMD, PC
• Maria Claudia Rey, D.D.S.
• Shaquit S Reyad
• Ana Reyes de Hernandez

• Clinic/Center in Washington, DC
• Providers in Washington, DC by specialty
• Clinic/Center in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.

Verify at the official NPI Registry.