NPIMap

Organization Active NPI

Revive Colorado, PC

  • Primary Care Clinic/Center
  • Durango, CO
National Provider Identifier
1033860754
Registry record updated Jan 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
REVIVE COLORADO, PC
Practice address
72 Suttle St Unit M
Durango, CO 81303-6829
Phone
(970) 828-3030
NPI assigned
Jan 13, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2022

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

Authorized official

Name
Dr. Daniel Caplin, DONPI 1033277371
Title
Medical Director
Phone
(709) 828-3030

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infusion Therapy Clinic/Center 261QI0500X
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

72 Suttle St Unit M
Durango, CO 81303-6829

Mailing address

72 Suttle St Unit M
Durango, CO 81303-6829
Phone (970) 828-3030

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dcaplin@fourcornersketamine.com Four Corners Ketamine Center

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1642032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642032000000",
    "number": "1033860754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 SUTTLE ST UNIT M",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813036829",
            "telephone_number": "970-828-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 SUTTLE ST UNIT M",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813036829",
            "telephone_number": "970-828-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE COLORADO, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-13",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A",
        "authorized_official_last_name": "CAPLIN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "709-828-3030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dcaplin@fourcornersketamine.com",
            "affiliation": "Y",
            "affiliationName": "Four Corners Ketamine Center",
            "address_1": "72 Suttle St Unit M",
            "city": "Durango",
            "state": "CO",
            "country_code": "US",
            "postal_code": "813036829",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.