NPIMap

Organization Active NPI

Revival Transportation

  • Non-emergency Medical Transport (VAN)
  • Ukiah, CA
National Provider Identifier
1780425611
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
Legal business name
REVIVAL TRANSPORTATION
Practice address
521 Capps LN
Ukiah, CA 95482-7227
Phone
(707) 376-5086
NPI assigned
Jun 4, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Authorized official

Name
Ashley Nicole ElliottNPI 1073242673
Title
Transportation Provider
Phone
(707) 376-5086

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X Primary

Addresses

Primary practice location

521 Capps LN
Ukiah, CA 95482-7227

Mailing address

521 Capps LN
Ukiah, CA 95482-7227
Phone (707) 376-5086

National Provider Directory

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.

NPI Registry JSON

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

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722297600000",
    "number": "1780425611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 CAPPS LN",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954827227",
            "telephone_number": "707-376-5086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 CAPPS LN",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954827227",
            "telephone_number": "707-376-5086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVAL TRANSPORTATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "TRANSPORTATION PROVIDER",
        "authorized_official_telephone_number": "707-376-5086"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ukiah, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; 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.