NPIMap

Organization Active NPI

Revolutionary Health Services, LLC

  • Family Medicine Physician
  • Washington Crossing, PA
National Provider Identifier
1609210350
Registry record updated Apr 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD048097L Issued in PA
Legal business name
REVOLUTIONARY HEALTH SERVICES, LLC
Practice address
1121 General Washington Mem Blvd
Washington Crossing, PA 18977-1366
Phone
(215) 321-1371
Fax
(215) 321-1378
NPI assigned
Apr 24, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2013

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

Authorized official

Name
Charles Whitney III, M.D.
Title
Owner/Physician
Phone
(215) 321-1371

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X MD048097L PA Primary

Addresses

Primary practice location

1121 General Washington Mem Blvd
Washington Crossing, PA 18977-1366

Mailing address

1121 General Washington Mem Blvd
Washington Crossing, PA 18977-1366
Phone (215) 321-1371

National Provider Directory

National Provider Directory

Locations

1121 General Washington Mem Blvd
Washington Xing, PA 18977
Phone (215) 321-1371

NPI Registry JSON

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

{
    "created_epoch": "1366761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366761600000",
    "number": "1609210350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 GENERAL WASHINGTON MEM BLVD",
            "city": "WASHINGTON CROSSING",
            "state": "PA",
            "postal_code": "189771366",
            "telephone_number": "215-321-1371",
            "fax_number": "215-321-1378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 GENERAL WASHINGTON MEM BLVD",
            "city": "WASHINGTON CROSSING",
            "state": "PA",
            "postal_code": "189771366",
            "telephone_number": "215-321-1371",
            "fax_number": "215-321-1378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVOLUTIONARY HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-24",
        "last_updated": "2013-04-24",
        "status": "A",
        "authorized_official_last_name": "WHITNEY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "215-321-1371",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD048097L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington Crossing, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2013; 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.