Bonita Revis

Primary specialty

Home Health AideTaxonomy code 374U00000X

License

401191400111 Issued in OH

Practice address

2325 Selma Ave
Youngstown, OH 44504-1305

Phone

(850) 851-7399

NPI assigned

Dec 7, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Traveling Angels LLC

  • Home Health Aide
  • Youngstown, OH
  • NPI 1144190513
  NPD Authorized official

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

{
    "created_epoch": "1512604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1568977858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 SELMA AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445041305",
            "telephone_number": "850-851-7399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 SELMA AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445041305",
            "telephone_number": "850-851-7399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3036 Red Fox Run Dr NW",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "OH",
            "postal_code": "444851576",
            "country_code": "US",
            "telephone_number": "850-459-4041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REVIS",
        "first_name": "BONITA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-07",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "OH",
            "license": "401191400111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christian Repomonto, RN
• Jeffrey D Resch, D.O.
• Allison Resetar, OT
• Kimberly Restaino, RPH
• Dionne L Retort, PSYCHIATRIC LPN
• Ashley S Reyes
• Carmelita R Reyes, DPM
• Nicole Reyes, DO
• John Vincent Arellano Reyles, M.D.
• Jasmaine Reynolds

• Home Health Aide in Youngstown, OH
• Providers in Youngstown, OH by specialty
• Home Health Aide in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.