Active NPI
Christopher James Revis, PH.D.
- Clinical Psychologist
- Sheppard Afb, TX
National Provider Identifier
1962597419
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 23872
- Practice address
- 149 Hart St
Sheppard Afb, TX 76311 - Phone
- (940) 676-4945
- Fax
- (940) 676-2210
- NPI assigned
- Oct 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 23872 | TX | Primary |
Addresses
Primary practice location
149 Hart St
Sheppard Afb, TX 76311
Mailing address
149 Hart St
Sheppard Afb, TX 76311
Phone (940) 676-4945
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962597419",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "149 HART ST",
"city": "SHEPPARD AFB",
"state": "TX",
"postal_code": "76311",
"telephone_number": "940-676-4945",
"fax_number": "940-676-2210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "149 HART ST",
"city": "SHEPPARD AFB",
"state": "TX",
"postal_code": "76311",
"telephone_number": "940-676-4945",
"fax_number": "940-676-2210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REVIS",
"first_name": "CHRISTOPHER",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "23872",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sheppard Afb, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.