Revive Medical Urgent Care LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

REVIVE MEDICAL URGENT CARE LLC

Practice address

4215 N Classen Blvd Ste 100
Oklahoma City, OK 73118-2426

Phone

(405) 673-7856

Fax

(619) 374-7045

NPI assigned

Aug 6, 2019

Organization subpart

No

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

Authorized official

Name

Kevin Brown, DC

Title

Owner

Phone

(951) 440-1652

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1565049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573516800000",
    "number": "1447805544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 57390",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731577390",
            "telephone_number": "405-603-4901",
            "fax_number": "405-936-0561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4215 N CLASSEN BLVD STE 100",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731182426",
            "telephone_number": "405-673-7856",
            "fax_number": "619-374-7045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE MEDICAL URGENT CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-06",
        "last_updated": "2019-11-12",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-440-1652",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Revive Health of Oklahoma LLC
• Revive Health Services
• Revive Hormone Clinic PLLC
• Revive Infusion
• Revive Medical LLC
• Revive Performance, Inc.
• Revive Therapy Plus Wellness
• Darnell Rex, MS
• Stephanie Rex
• Jr Rey

• Family Medicine Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.