Revelation Inc.

Primary specialty

Mastectomy FitterTaxonomy code 224900000X

Legal business name

REVELATION INC.

Practice address

111 E Water St
Decorah, IA 52101-1801

Phone

(563) 382-6212

Fax

(563) 382-6420

NPI assigned

Jul 11, 2019

Organization subpart

No

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

Authorized official

Name

Renee CarlsonNPI 1659923654

Title

Owner

Phone

(563) 382-6212

Specialties & licenses 1

Addresses

Other names 1

• Revelation/Merle Norman Cosmetics/Les Wigs Renee Doing business as

Electronic endpoints 7

Locations

Practitioners 1

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

• Renee Beth Carlson

  • Mastectomy Fitter
  • Decorah, IA
  • NPI 1659923654
  NPD Authorized official

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

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637193600000",
    "number": "1730731589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E WATER ST",
            "city": "DECORAH",
            "state": "IA",
            "postal_code": "521011801",
            "telephone_number": "563-382-6212",
            "fax_number": "563-382-6420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E WATER ST",
            "city": "DECORAH",
            "state": "IA",
            "postal_code": "521011801",
            "telephone_number": "563-382-6212",
            "fax_number": "563-382-6420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVELATION INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-11",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "RENEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "563-382-6212"
    },
    "taxonomies": [
        {
            "code": "224900000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Mastectomy Fitter",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmnrevelation@live.com",
            "affiliation": "N",
            "endpointDescription": "Business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "111 E Water St",
            "city": "Decorah",
            "state": "IA",
            "country_code": "US",
            "postal_code": "521011801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmnrevelation@live.com",
            "affiliation": "N",
            "endpointDescription": "Business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "111 E Water St",
            "city": "Decorah",
            "state": "IA",
            "country_code": "US",
            "postal_code": "521011801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmnrevelation@live.com",
            "affiliation": "N",
            "endpointDescription": "Business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "111 E Water St",
            "city": "Decorah",
            "state": "IA",
            "country_code": "US",
            "postal_code": "521011801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmnrevelation@live.com",
            "affiliation": "N",
            "endpointDescription": "Business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "111 E Water St",
            "city": "Decorah",
            "state": "IA",
            "country_code": "US",
            "postal_code": "521011801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmnrevelation@live.com",
            "affiliation": "N",
            "endpointDescription": "Business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "111 E Water St",
            "city": "Decorah",
            "state": "IA",
            "country_code": "US",
            "postal_code": "521011801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmnrevelation@live.com",
            "affiliation": "N",
            "endpointDescription": "Business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "111 E Water St",
            "city": "Decorah",
            "state": "IA",
            "country_code": "US",
            "postal_code": "521011801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmnrevelation@live.com",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "111 E Water St",
            "city": "Decorah",
            "state": "IA",
            "country_code": "US",
            "postal_code": "521011801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Revelation/Merle Norman Cosmetics/Les Wigs Renee",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelly Vernon Reagan, D.C.
• Joetta M Redlin, REGISTERED DIETICIAN
• Samantha Jo Mikota Reicks, DNP, ARNP
• William J Remington, M.D.
• Restorative Therapy & Psychiatric Care
• Lori Rissman, PHARMD
• Andrew J Rix, MPT, CSCS
• Seth Robinson, LMSW
• Ashley Roney, HCP
• Christine Sue Roth, CRNA

• Mastectomy Fitter in Decorah, IA
• Providers in Decorah, IA by specialty
• Mastectomy Fitter in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.