NPIMap

Organization Active NPI

Revitalize CDC

  • Contractor
  • Springfield, MA
National Provider Identifier
1538908751
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
Legal business name
REVITALIZE CDC
Practice address
240 Cadwell Dr
Springfield, MA 01104-1743
Phone
(413) 788-0014
NPI assigned
May 20, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Authorized official

Name
Rita LongeNPI 1427577493
Title
Senior Manager
Phone
(413) 472-6850

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ContractorGroup: 193200000X MULTI-SPECIALTY GROUP 171W00000X Primary
Home Modifications ContractorGroup: 193200000X MULTI-SPECIALTY GROUP 171WH0202X

Addresses

Primary practice location

240 Cadwell Dr
Springfield, MA 01104-1743

Mailing address

240 Cadwell Dr
Springfield, MA 01104-1743

Other names 1

  • Revitalize CDC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Revitalize CDC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

240 Cadwell Dr
Springfield, MA 01104
Phone (413) 788-0014

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1716163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721174400000",
    "number": "1538908751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 CADWELL DR",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011041743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 CADWELL DR",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011041743",
            "telephone_number": "413-788-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVITALIZE CDC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-20",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A",
        "authorized_official_last_name": "LONGE",
        "authorized_official_first_name": "RITA",
        "authorized_official_title_or_position": "SENIOR MANAGER",
        "authorized_official_telephone_number": "413-472-6850"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171WH0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Contractor, Home Modifications",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revitalize CDC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Revitalize CDC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; 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.