Active NPI
Revolution Health Medical Center, PC
- Naturopath
- Phoenix, AZ
National Provider Identifier
1699897041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Naturopath
- 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
- 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
- Dr. Julie A Gorman, NMD
- Title
- Chief Executive Officer
- Phone
- (602) 265-1774
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | |||
| Naturopath | 175F00000X | Primary | ||
| Massage Therapist | 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 Center
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Clinic/Center
- Phoenix, AZ
- NPI 1942671060
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.