Synaptic Psychiatry LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

SYNAPTIC PSYCHIATRY LLC

Doing business as

Revitalize and Optimize Clinic

Practice address

906 W University Ave Ste 150
Flagstaff, AZ 86001-2603

Phone

(928) 248-8082

Fax

(855) 930-4003

NPI assigned

Apr 30, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Phillip Casey Dubravcic, PMHNPNPI 1962910760

Title

Owner/Operator/Ceo

Phone

(928) 248-8082

Specialties & licenses 6

Addresses

Other names 1

• Revitalize and Optimize Clinic Doing business as

Locations

Practitioners 1

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.

• Phillip Casey Dubravcic, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Flagstaff, AZ
  • NPI 1962910760
  NPD Authorized official

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

{
    "created_epoch": "1714435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714435200000",
    "number": "1831946656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 W UNIVERSITY AVE STE 150",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860012603",
            "telephone_number": "928-248-8082",
            "fax_number": "855-930-4003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 W UNIVERSITY AVE STE 150",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860012603",
            "telephone_number": "928-248-8082",
            "fax_number": "855-930-4003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1785 W State Route 89A Ste 2B",
            "address_purpose": "LOCATION",
            "city": "Sedona",
            "state": "AZ",
            "postal_code": "863365576",
            "country_code": "US",
            "telephone_number": "928-325-2323",
            "fax_number": "855-930-4003",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3173 N Windsong Dr",
            "address_purpose": "LOCATION",
            "city": "Prescott Valley",
            "state": "AZ",
            "postal_code": "863142240",
            "country_code": "US",
            "telephone_number": "928-248-8082",
            "fax_number": "855-930-4003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SYNAPTIC PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-30",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "DUBRAVCIC",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "CASEY",
        "authorized_official_title_or_position": "OWNER/OPERATOR/CEO",
        "authorized_official_telephone_number": "928-248-8082",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revitalize and Optimize Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cassandra L Swenson, LPC
• Switzer Medical Inc (Jane Barnwell, MD)
• Michele Marie Switzer, M.D.
• Sumner Jay Sydeman, PH.D.
• Nicole Renee Sydow, M.D.
• Jessica Rose Szczepanski, PHD, RDN
• Henry Joseph Tagle III, D.M.D.
• Renee Takehara
• Tiana Tallant, PT, DPT
• Alexander Kerway Tan, L.AC.

• Psychiatry Physician in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Psychiatry Physician in Arizona

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