Revere Home Care

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

REVERE HOME CARE

Practice address

160 NW Gilman Blvd Ste 310
Issaquah, WA 98027-2549

Phone

(425) 245-5540

Fax

(833) 239-7087

NPI assigned

Jan 12, 2026

Last updated

Jan 12, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Wyatt Rex RoderickNPI 1295626588

Title

President

Phone

(206) 605-8854

Specialties & licenses 1

Addresses

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.

• Wyatt Roderick

  • In Home Supportive Care Agency
  • Issaquah, WA
  • NPI 1295626588
  NPD Authorized official

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

{
    "created_epoch": "1768176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768176000000",
    "number": "1841158581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 NW GILMAN BLVD STE 310",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272549",
            "telephone_number": "425-245-5540",
            "fax_number": "833-239-7087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 NW GILMAN BLVD STE 310",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272549",
            "telephone_number": "425-245-5540",
            "fax_number": "833-239-7087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVERE HOME CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-12",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A",
        "authorized_official_last_name": "RODERICK",
        "authorized_official_first_name": "WYATT",
        "authorized_official_middle_name": "REX",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "206-605-8854"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Beau Reilly, PH.D.
• Aislinn Tercie-Jeness Rennison, DACM
• Lisa A. Rensberger, PA-C
• Resilient Connections, PLLC (Janet Moczulewski)
• Violet S Resnick, LICSW
• Revive Physical Therapy
• Anthony Kain Reyes
• Maria Coleen Ochoa Reyes, PHARMD
• Molly Kay Reyes, LMT
• Richard Calvo DDS PLLC

• In Home Supportive Care Agency in Issaquah, WA
• Providers in Issaquah, WA by specialty
• In Home Supportive Care Agency in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2026; 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.