NPIMap

Organization Active NPI

Revolution Health Medical Center, PC

  • Naturopath
  • Phoenix, AZ
National Provider Identifier
1699897041
Registry record updated Jan 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
Legal business name
REVOLUTION HEALTH MEDICAL CENTER, PC
Practice address
1641 E Osborn Rd
Suite 6
Phoenix, AZ 85016-7146
Phone
(602) 265-1774
Fax
(602) 265-1738
NPI assigned
Apr 5, 2007
Last updated
Jan 2, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2015

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

Authorized official

Name
Dr. Julie A Gorman, NMDNPI 1215907720
Title
Chief Executive Officer
Phone
(602) 265-1774

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X
NaturopathGroup: 193200000X MULTI-SPECIALTY GROUP 175F00000X Primary
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X

Addresses

Primary practice location

1641 E Osborn Rd
Suite 6
Phoenix, AZ 85016-7146

Mailing address

1641 E Osborn Rd
Suite 6
Phoenix, AZ 85016-7146
Phone (602) 265-1774

National Provider Directory

National Provider Directory
Tax ID family
Revolution Health Medical Center2 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.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1175731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420156800000",
    "number": "1699897041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1641 E OSBORN RD",
            "address_2": "SUITE 6",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167146",
            "telephone_number": "602-265-1774",
            "fax_number": "602-265-1738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1641 E OSBORN RD",
            "address_2": "SUITE 6",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167146",
            "telephone_number": "602-265-1774",
            "fax_number": "602-265-1738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVOLUTION HEALTH MEDICAL CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-05",
        "last_updated": "2015-01-02",
        "status": "A",
        "authorized_official_last_name": "GORMAN",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "602-265-1774",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "NMD"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Naturopath",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.