Revitalize Health LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

REVITALIZE HEALTH LLC

Practice address

13535 Morning Sky CT
Peyton, CO 80831-8392

Phone

(719) 695-0756

NPI assigned

Dec 10, 2020

Organization subpart

No

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

Authorized official

Name

Miriam D Hughes, WHNP-BC, CNM

Title

Primary Member

Phone

(719) 695-0756

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1607558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612396800000",
    "number": "1083210314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13535 MORNING SKY CT",
            "city": "PEYTON",
            "state": "CO",
            "postal_code": "808318392",
            "telephone_number": "719-695-0756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13535 MORNING SKY CT",
            "city": "PEYTON",
            "state": "CO",
            "postal_code": "808318392",
            "telephone_number": "719-695-0756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVITALIZE HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-10",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A",
        "authorized_official_last_name": "HUGHES",
        "authorized_official_first_name": "MIRIAM",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRIMARY MEMBER",
        "authorized_official_telephone_number": "719-695-0756",
        "authorized_official_credential": "WHNP-BC, CNM"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Peyton, CO
• Providers in Peyton, CO by specialty
• Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2021; 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.