Revive DME

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

Legal business name

REVIVE DME

Practice address

2525 NW Expressway Ste 208
Oklahoma City, OK 73112-7641

Phone

(405) 577-2266

NPI assigned

Oct 24, 2024

Organization subpart

No

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

Authorized official

Name

Adam Black

Title

Owner

Phone

(917) 769-2819

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1729728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729728000000",
    "number": "1689496341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 NW EXPRESSWAY STE 208",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731127641",
            "telephone_number": "405-577-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 NW EXPRESSWAY STE 208",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731127641",
            "telephone_number": "405-577-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE DME",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-24",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-769-2819"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Revelation Enterprises Inc
• Revelation Medical of Oklahoma City LLC
• Revitalize Nutrition Corp
• Revitalizing Hope, LLC
• Revive Clinic LLC
• Revive Health of Oklahoma LLC
• Revive Health Services
• Revive Hormone Clinic PLLC
• Revive Infusion
• Revive Medical LLC

• Oxygen Equipment & Supplies (DME) in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Oxygen Equipment & Supplies (DME) in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; 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.