Revolution Performance, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

REVOLUTION PERFORMANCE, LLC

Practice address

4516 Kenny Rd Ste B
Columbus, OH 43220-3786

Phone

(614) 859-2785

NPI assigned

Apr 3, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Ryan A Queen, PT, DPT, CSCS, PN1NPI 1588275093

Title

Owner/Ceo

Phone

(618) 670-3788

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ryan Anthony Queen, PT, DPT, CSCS

  • Physical Therapist
  • Pickerington, OH
  • NPI 1588275093
  NPD Authorized official

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

{
    "created_epoch": "1648944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648944000000",
    "number": "1699416818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2759 BERLIN STATION RD",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430159406",
            "telephone_number": "618-670-3788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4516 KENNY RD STE B",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432203786",
            "telephone_number": "614-859-2785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVOLUTION PERFORMANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-03",
        "last_updated": "2022-04-03",
        "certification_date": "2022-04-03",
        "status": "A",
        "authorized_official_last_name": "QUEEN",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "618-670-3788",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT, CSCS, PN1"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alberto Enrique Revelo, M.D.
• Celena Lenette Revels-Jones
• Courtney Revels-Turner
• Revision Advanced Surgery Center Inc
• Revision Technologies, Inc.
• Abigail Rex, MD
• Andrea R Rex, CPHT
• Elisandra Reyes-Perez, DDS
• Andrea Christina Reyes
• Cleo Zarina Alejo Reyes, MD

• Physical Therapist in Columbus, OH
• Providers in Columbus, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2022; 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.