Active NPI
Revamed Center for Emotional Wellbeing, LLC
- Psychiatry Physician
- Boca Raton, FL
National Provider Identifier
1093325243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- Legal business name
- REVAMED CENTER FOR EMOTIONAL WELLBEING, LLC
- Practice address
- 7000 W Palmetto Park Rd Ste 201
Boca Raton, FL 33433-3430 - Phone
- (561) 391-2770
- Fax
- (561) 391-2930
- NPI assigned
- Aug 3, 2020
- 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
- Melissa Stieler
- Title
- Credentialing Manager
- Phone
- (561) 432-2164
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | |||
| Developmental - Behavioral Pediatrics Physician | 2080P0006X | |||
| Psychiatry Physician | 2084P0800X | Primary | ||
| Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist | 364SP0807X |
Addresses
Primary practice location
7000 W Palmetto Park Rd Ste 201
Boca Raton, FL 33433-3430
Mailing address
8140 Okeechobee Blvd Ste a&B
West Palm Beach, FL 33411-2003
Phone (561) 293-4301
National Provider Directory
National Provider DirectoryLocations
7000 W Palmetto Park Rd
Ste 201
Boca Raton, FL 33433
Phone (561) 270-2280
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Boynton Beach, FL
- NPI 1598062630
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596412800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1596412800000",
"number": "1093325243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8140 OKEECHOBEE BLVD STE A&B",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334112003",
"telephone_number": "561-293-4301",
"fax_number": "561-293-4301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7000 W PALMETTO PARK RD STE 201",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334333430",
"telephone_number": "561-391-2770",
"fax_number": "561-391-2930"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "REVAMED CENTER FOR EMOTIONAL WELLBEING, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-08-03",
"last_updated": "2020-08-03",
"certification_date": "2020-08-03",
"status": "A",
"authorized_official_last_name": "STIELER",
"authorized_official_first_name": "MELISSA",
"authorized_official_title_or_position": "CREDENTIALING MANAGER",
"authorized_official_telephone_number": "561-432-2164"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "2080P0006X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics, Developmental - Behavioral Pediatrics",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": true
},
{
"code": "364SP0807X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Adolescent",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boca Raton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.