Revitalized Health, LLC.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

REVITALIZED HEALTH, LLC.

Practice address

7761 Shaffer Pkwy Ste 120
Littleton, CO 80127-3729

Phone

(720) 361-2302

Fax

(720) 728-8617

NPI assigned

May 7, 2018

Organization subpart

No

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

Authorized official

Name

Mr. John Richard Flauding, NP-C

Title

Owner/Nurse Practitioner

Phone

(720) 361-2302

Specialties & licenses 1

Addresses

Other names 1

• REVITALIZED HEALTH Doing business as

Locations

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

{
    "created_epoch": "1525651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525651200000",
    "number": "1679062483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7761 SHAFFER PKWY STE 120",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801273729",
            "telephone_number": "720-361-2302",
            "fax_number": "720-728-8617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7761 SHAFFER PKWY STE 120",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801273729",
            "telephone_number": "720-361-2302",
            "fax_number": "720-728-8617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVITALIZED HEALTH, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-07",
        "last_updated": "2018-05-07",
        "status": "A",
        "authorized_official_last_name": "FLAUDING",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER/NURSE PRACTITIONER",
        "authorized_official_telephone_number": "720-361-2302",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NP-C"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "REVITALIZED HEALTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.