Active NPI
Revive Psychiatry, PLLC
- Psychiatric/Mental Health Nurse Practitioner
- Durant, OK
National Provider Identifier
1699647701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- Legal business name
- REVIVE PSYCHIATRY, PLLC
- Practice address
- 720 Bryan Dr Ste C
Durant, OK 74701-7032 - Phone
- (580) 754-4164
- Fax
- (580) 359-0468
- NPI assigned
- Sep 18, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jonathan Kaminar, APRN, PMHNP-BC
- Title
- Owner
- Phone
- (580) 754-4164
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | Primary |
Addresses
Primary practice location
720 Bryan Dr Ste C
Durant, OK 74701-7032
Mailing address
720 Bryan Dr Ste C
Durant, OK 74701-7032
Phone (580) 754-4164
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
720 Bryan Dr
Ste C
Durant, OK 74701
Phone (580) 754-4164
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Psychiatric/Mental Health Nurse Practitioner
- McKinney, TX
- NPI 1427780279
OK
-
- Acute Care Nurse Practitioner
- Dallas, TX
- NPI 1740881648
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1758153600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1758844800000",
"number": "1699647701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "720 BRYAN DR STE C",
"city": "DURANT",
"state": "OK",
"postal_code": "747017032",
"telephone_number": "580-754-4164",
"fax_number": "580-359-0468"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 BRYAN DR STE C",
"city": "DURANT",
"state": "OK",
"postal_code": "747017032",
"telephone_number": "580-754-4164",
"fax_number": "580-359-0468"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "REVIVE PSYCHIATRY, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-09-18",
"last_updated": "2025-09-26",
"certification_date": "2025-09-26",
"status": "A",
"authorized_official_last_name": "KAMINAR",
"authorized_official_first_name": "JONATHAN",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "580-754-4164",
"authorized_official_credential": "APRN, PMHNP-BC"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durant, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.