Revolution Kimwell LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

REVOLUTION KIMWELL LLC

Practice address

495 New Boston Rd
Fall River, MA 02720-5835

Phone

(508) 679-0106

NPI assigned

May 6, 2019

Organization subpart

No

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

Authorized official

Name

Joseph Deutsch

Title

Principal

Phone

(508) 679-0106

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557100800000",
    "number": "1205491271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 NEW BOSTON RD",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027205835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 NEW BOSTON RD",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027205835",
            "telephone_number": "508-679-0106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVOLUTION KIMWELL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-06",
        "last_updated": "2019-05-06",
        "status": "A",
        "authorized_official_last_name": "DEUTSCH",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "508-679-0106"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Staci M Resnick, M.D.
• Respiratory Health Associates Inc
• Claudette Y Reuss, NP
• Samantha Revane
• Revolution at Sarah Brayton Place LLC
• Ira H. Rex III, M.D.
• Danelyn Odette Reyes
• Kiarah Reyes, BA
• Mya Lee Reyes
• Shannon Marie Reynolds

• Skilled Nursing Facility in Fall River, MA
• Providers in Fall River, MA by specialty
• Skilled Nursing Facility in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2019; 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.