Revention Medicine

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

RT851444 Issued in OH

Legal business name

REVENTION MEDICINE

Practice address

5900 N Main St
Dayton, OH 45415-3150

Phone

(937) 681-9507

NPI assigned

Jan 31, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Charles Misja

Title

Owner

Phone

(937) 681-9507

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1485820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485820800000",
    "number": "1306383153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 N MAIN ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454153150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 N MAIN ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454153150",
            "telephone_number": "937-681-9507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVENTION MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-31",
        "last_updated": "2017-01-31",
        "status": "A",
        "authorized_official_last_name": "MISJA",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-681-9507",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "OH",
            "license": "RT851444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Non-Pharmacy Dispensing Site in Dayton, OH
• Providers in Dayton, OH by specialty
• Non-Pharmacy Dispensing Site in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2017; 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.