Revelation Medical LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

REVELATION MEDICAL LLC

Practice address

4636 S Harvard Ave Ste 104
Tulsa, OK 74135-2908

Phone

(918) 398-8900

NPI assigned

Oct 21, 2021

Organization subpart

No

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

Authorized official

Name

James Linn

Title

Authorized Official

Phone

(918) 398-8900

Specialties & licenses 2

Addresses

Practitioners 2

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

• Shane Foster, DPT

  • Physical Therapist
  • Tulsa, OK
  • NPI 1528708344
  NPD
• Jaimie Kurian, APRN

  • Family Nurse Practitioner
  • Tulsa, OK
  • NPI 1790489847
  NPD

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

{
    "created_epoch": "1634774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634774400000",
    "number": "1710640255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4636 S HARVARD AVE STE 104",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352908",
            "telephone_number": "918-398-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4636 S HARVARD AVE STE 104",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352908",
            "telephone_number": "918-398-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVELATION MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-21",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A",
        "authorized_official_last_name": "LINN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "918-398-8900"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Retina and Vitreous of Oklahoma, P.L.L.C.
• Retina Associates Inc (Raymond E. Townsend M D)
• Emily Retkowski, COTA/L
• Nathan G Reusser, DO
• Leron Revan
• Revelation Medical of Tulsa LLC
• Andreas Frank Revelis, M.D.
• Reverence Counseling & Consulting
• Logan Revill, APRN
• Grayson Revilla

• Family Medicine Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; 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.