Stephanie M Revels MD PA

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

0428042 Issued in KS

Legal business name

STEPHANIE M REVELS MD PA

Practice address

8249 W 95 TH Street
Suite 108
Overland Park, KS 66212-3200

Phone

(913) 484-5052

NPI assigned

Nov 29, 2010

Last updated

Jul 17, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stephanie M Revels, MD

Title

Physician

Phone

(913) 484-5052

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1290988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342483200000",
    "number": "1427350339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8249 W 95TH ST",
            "address_2": "SUITE 108",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662123217",
            "telephone_number": "913-484-5052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8249 W 95 TH STREET",
            "address_2": "SUITE 108",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662123200",
            "telephone_number": "913-484-5052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHANIE M REVELS MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-29",
        "last_updated": "2012-07-17",
        "status": "A",
        "authorized_official_last_name": "REVELS",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "913-484-5052",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "KS",
            "license": "0428042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Point of Service in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Point of Service in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2012; 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.