NPIMap

Organization Active NPI

Revelation Therapy Health Services

  • Physical Therapist
  • East Orange, NJ
National Provider Identifier
1043229651
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
401OA01008800 Issued in NJ
Legal business name
REVELATION THERAPY HEALTH SERVICES
Practice address
115 Evergreen PL
East Orange, NJ 07018-2006
Phone
(862) 452-6086
Fax
(973) 677-1655
NPI assigned
Aug 5, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Tibisay R NisbettNPI 1821169384
Title
Owner
Phone
(862) 452-6086

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 401OA01008800 NJ Primary

Addresses

Primary practice location

115 Evergreen PL
East Orange, NJ 07018-2006

Mailing address

840 S 13TH St
Newark, NJ 07108-1316
Phone (862) 452-6086

National Provider Directory

National Provider Directory
Tax ID family
Revelation Therapy Health Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

115 Evergreen Pl
East Orange, NJ 07018
Phone (862) 452-6086

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043229651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 S 13TH ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071081316",
            "telephone_number": "862-452-6086",
            "fax_number": "973-374-4494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 EVERGREEN PL",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070182006",
            "telephone_number": "862-452-6086",
            "fax_number": "973-677-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVELATION THERAPY HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NISBETT",
        "authorized_official_first_name": "TIBISAY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "862-452-6086",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "401OA01008800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.