NPIMap

Organization Active NPI

Revive Athletics, Inc

  • Community/Behavioral Health Agency
  • New Orleans, LA
National Provider Identifier
1669855177
Registry record updated Jul 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
REVIVE ATHLETICS, INC
Practice address
201 St. Charles Ave.
Ste. 2500
New Orleans, LA 70170-2500
Phone
(504) 754-6904
Fax
(800) 675-4619
NPI assigned
Jul 1, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2015

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

Authorized official

Name
Matthew Harrell
Title
Owner
Phone
(678) 308-5520

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

201 St. Charles Ave.
Ste. 2500
New Orleans, LA 70170-2500

Mailing address

201 St. Charles Ave.
Ste. 2500
New Orleans, LA 70170-2500
Phone (504) 754-6904

National Provider Directory

National Provider Directory
Tax ID family
D H Consulting LLC2 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.

NPI Registry JSON

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435708800000",
    "number": "1669855177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 ST. CHARLES AVE.",
            "address_2": "STE. 2500",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701702500",
            "telephone_number": "504-754-6904",
            "fax_number": "800-675-4619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 ST. CHARLES AVE.",
            "address_2": "STE. 2500",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701702500",
            "telephone_number": "504-754-6904",
            "fax_number": "800-675-4619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE ATHLETICS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-01",
        "last_updated": "2015-07-01",
        "status": "A",
        "authorized_official_last_name": "HARRELL",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-308-5520"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; 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.