Revelation Wellness LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1630 Issued in NE

Legal business name

REVELATION WELLNESS LLC

Practice address

316 E Douglas St
Oneill, NE 68763-1830

Phone

(402) 336-7133

Fax

(877) 207-3713

NPI assigned

Aug 8, 2013

Last updated

Aug 19, 2013By 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

Trent Shoemaker, DCNPI 1184866204

Title

Owner / Chiropractor

Phone

(402) 336-7133

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Trent M Shoemaker, D.C.

  • Chiropractor
  • Lake Oswego, OR
  • NPI 1184866204

  NE

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1375920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376870400000",
    "number": "1427480797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 E DOUGLAS ST",
            "city": "ONEILL",
            "state": "NE",
            "postal_code": "687631830",
            "telephone_number": "402-336-7133",
            "fax_number": "877-207-3713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 E DOUGLAS ST",
            "city": "ONEILL",
            "state": "NE",
            "postal_code": "687631830",
            "telephone_number": "402-336-7133",
            "fax_number": "877-207-3713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVELATION WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-08",
        "last_updated": "2013-08-19",
        "status": "A",
        "authorized_official_last_name": "SHOEMAKER",
        "authorized_official_first_name": "TRENT",
        "authorized_official_title_or_position": "OWNER / CHIROPRACTOR",
        "authorized_official_telephone_number": "402-336-7133",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1630",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "NE",
            "license": "2629",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda Lee Podany
• Alyssa Brianne Poessnecker
• Stephanie Spring Prouty, RN
• Catilyn Reiser
• Tayler Lynn Rentschler, APRN
• Ashley Rewinkel
• Sandra Richards
• Cheryl Riege
• Donella G Ross
• Jodi Ross

• Chiropractor in O'Neill, NE
• Providers in O'Neill, NE by specialty
• Chiropractor in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.