Individual provider Active NPI

Kimberly M. Rollheiser-Revilla, D.C.

  • Chiropractor
  • San Marcos, CA
National Provider Identifier
1164446266
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC24577 Issued in CA
Practice address
555 S Rancho Santa Fe Rd
Suite 200
San Marcos, CA 92078-3698
Phone
(760) 736-0286
Fax
(760) 736-3113
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC24577 CA Primary

Addresses

Primary practice location

555 S Rancho Santa Fe Rd
Suite 200
San Marcos, CA 92078-3698

Mailing address

555 S Rancho Santa Fe Rd
Suite 200
San Marcos, CA 92078-3698
Phone (760) 736-0286

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164446266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 S RANCHO SANTA FE RD",
            "address_2": "SUITE 200",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920783698",
            "telephone_number": "760-736-0286",
            "fax_number": "760-736-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 S RANCHO SANTA FE RD",
            "address_2": "SUITE 200",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920783698",
            "telephone_number": "760-736-0286",
            "fax_number": "760-736-3113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLLHEISER-REVILLA",
        "first_name": "KIMBERLY",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC24577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.