NPIMap

Organization Active NPI

Revive Health of Oklahoma LLC

Doing business as Revive Health Of Oklahoma

  • General Practice Physician
  • Oklahoma City, OK
National Provider Identifier
1740842327
Registry record updated Jul 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
REVIVE HEALTH OF OKLAHOMA LLC
Doing business as
Revive Health Of Oklahoma
Practice address
4215 N Classen Blvd Ste 103
Oklahoma City, OK 73118-2426
Phone
(405) 673-7856
NPI assigned
Jul 3, 2019
Last updated
Jul 3, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2019

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

Authorized official

Name
Kevin M Brown, DC
Title
Owner
Phone
(405) 603-4901

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

4215 N Classen Blvd Ste 103
Oklahoma City, OK 73118-2426

Mailing address

4215 N Classen Blvd Ste 103
Oklahoma City, OK 73118-2426
Phone (405) 673-7856

Other names 1

  • Revive Health Of Oklahoma Doing business as

National Provider Directory

National Provider Directory

Locations

4215 N Classen Blvd
Ste 103
Oklahoma City, OK 73118
Phone (405) 673-7856

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1562112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562112000000",
    "number": "1740842327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4215 N CLASSEN BLVD STE 103",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731182426",
            "telephone_number": "405-673-7856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4215 N CLASSEN BLVD STE 103",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731182426",
            "telephone_number": "405-673-7856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE HEALTH OF OKLAHOMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-03",
        "last_updated": "2019-07-03",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-603-4901",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revive Health Of Oklahoma",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2019; 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.