Revenge Medical Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

REVENGE MEDICAL INC

Practice address

343 Elm St Ste 201
Reno, NV 89503-4538

Phone

(775) 670-6651

NPI assigned

Feb 17, 2023

Organization subpart

No

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

Authorized official

Name

Edin Abdagic, APRNNPI 1679900195

Title

Owner

Phone

(702) 690-1633

Specialties & licenses 1

Addresses

Tax ID family

Revenge Medical Inc2 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.

• Revenge Medical Inc

  • Specialist
  • Reno, NV
  • NPI 1942921200
  NPD tax ID

Practitioners 1

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

• Edin Abdagic, NP

  • Adult Health Nurse Practitioner
  • Reno, NV
  • NPI 1679900195
  NPD Authorized official

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

{
    "created_epoch": "1676592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676592000000",
    "number": "1629776737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 ELM ST STE 201",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895034538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 ELM ST STE 201",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895034538",
            "telephone_number": "775-670-6651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVENGE MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-17",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A",
        "authorized_official_last_name": "ABDAGIC",
        "authorized_official_first_name": "EDIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-690-1633",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anton Rets, M.D.
• Cathryn Heydon Retterath, RNFA
• Taylor Retterath
• Preston Reugebrink, PA-C
• Renee Angela Reveles, MSW, LCSW
• Revenge Medical Inc
• Kaelie Lynn Reviglio, DMD
• Amanda Revis
• Revive Health Senior Care LLC (Alta Skilled Nursing and Rehabilitation Center)
• Revive Health Senior Care LLC (Alta Skilled Nursing and Rehabilitation Center)

• Durable Medical Equipment & Medical Supplies in Reno, NV
• Providers in Reno, NV by specialty
• Durable Medical Equipment & Medical Supplies in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; 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.