Medical Revolution, LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

MEDICAL REVOLUTION, LLC

Practice address

215 Union Blvd
Suite 300
Lakewood, CO 80228-1839

Phone

(303) 520-2599

NPI assigned

Jul 21, 2016

Organization subpart

No

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

Authorized official

Name

Stuart Wilson

Title

Director

Phone

(303) 520-2599

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1469059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469059200000",
    "number": "1205289501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 UNION BLVD",
            "address_2": "SUITE 300",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802281839",
            "telephone_number": "303-520-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 UNION BLVD",
            "address_2": "SUITE 300",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802281839",
            "telephone_number": "303-520-2599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL REVOLUTION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-21",
        "last_updated": "2016-07-21",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "STUART",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "303-520-2599"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Medicine & Rehabilitation Physician in Lakewood, CO
• Providers in Lakewood, CO by specialty
• Physical Medicine & Rehabilitation Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2016; 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.