Alyssa Jane Revolinski

Primary specialty

Child Mental Illness Respite CareTaxonomy code 385HR2055X

Practice address

269435 S Elm Lane
Waterford, WI 53185

Phone

(262) 210-0272

NPI assigned

Sep 26, 2018

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

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

{
    "created_epoch": "1537920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537920000000",
    "number": "1649755695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33633 OAK KNOLL RD",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531056703",
            "telephone_number": "262-210-0272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269435 S ELM LANE",
            "city": "WATERFORD",
            "state": "WI",
            "postal_code": "53185",
            "telephone_number": "262-210-0272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVOLINSKI",
        "first_name": "ALYSSA",
        "middle_name": "JANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-26",
        "last_updated": "2018-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kendall Anne Radtke, PT, DPT
• Randall Schmidt MD
• Jennifer Lynn Reed
• Erin Noll Reich Olson, LCSW
• Christa Lynn Reimer, R.N.
• Riverside Chiropractic, LLC
• Nancy M Rofalikos-Welka, DO
• Sharon R Ruetz-Smith, D.D.S.
• Libby Rumary, FNP-BC
• Kimberly Ruona

• Child Mental Illness Respite Care in Waterford, WI
• Providers in Waterford, WI by specialty
• Child Mental Illness Respite Care in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2018; 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.