NPIMap

Organization Active NPI

Revival Skin Artistry

  • Other Specialist/Technologist
  • Lakewood, CO
National Provider Identifier
1669254710
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other Specialist/TechnologistTaxonomy code 246Z00000X
Legal business name
REVIVAL SKIN ARTISTRY
Practice address
10080 W 26TH Ave
Lakewood, CO 80215-1429
Phone
(720) 483-2006
NPI assigned
Oct 13, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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

Authorized official

Name
Carly D KesnerNPI 1528752904
Title
Owner
Phone
(720) 483-2006

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Other Specialist/TechnologistGroup: 193400000X SINGLE SPECIALTY GROUP 246Z00000X Primary

Addresses

Primary practice location

10080 W 26TH Ave
Lakewood, CO 80215-1429

Mailing address

10080 W 26TH Ave
Lakewood, CO 80215-1429

National Provider Directory

National Provider Directory

Locations

10080 W 26th Ave
Lakewood, CO 80215
Phone (720) 483-2006

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": "1697155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697155200000",
    "number": "1669254710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10080 W 26TH AVE",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802151429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10080 W 26TH AVE",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802151429",
            "telephone_number": "720-483-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVAL SKIN ARTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-13",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A",
        "authorized_official_last_name": "KESNER",
        "authorized_official_first_name": "CARLY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-483-2006"
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.