Revolution Incorporated

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

9225 Issued in NC

Legal business name

REVOLUTION INCORPORATED

Practice address

5310 Yadkin Rd
Fayetteville, NC 28303-3255

Phone

(910) 988-6974

Fax

(910) 425-4956

NPI assigned

Sep 11, 2007

Organization subpart

No

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

Authorized official

Name

Tremayne Thurman

Title

Director of Clinical Operations

Phone

(910) 401-9210

Specialties & licenses 3

Addresses

Tax ID family

Revolution Incorporated2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Revolution Incorporated

  • Physical Therapist
  • Fayetteville, NC
  • NPI 1164921862
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gwendolyn Taylor Scott, MSW

  • Clinical Social Worker
  • Fayetteville, NC
  • NPI 1205951449
  NPD

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674432000000",
    "number": "1972798007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 YADKIN RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283033255",
            "telephone_number": "910-988-6974",
            "fax_number": "910-425-4956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5310 YADKIN RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283033255",
            "telephone_number": "910-988-6974",
            "fax_number": "910-425-4956"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5860 Yadkin Rd",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283032668",
            "country_code": "US",
            "telephone_number": "910-491-5164",
            "fax_number": "910-229-3227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REVOLUTION INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-11",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A",
        "authorized_official_last_name": "THURMAN",
        "authorized_official_first_name": "TREMAYNE",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL OPERATIONS",
        "authorized_official_telephone_number": "910-401-9210"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "9225",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "5574",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Ryan Rettig, PHARMD
• Okisha Denna Reuben
• Korey Lee Revels, D.C.
• Kyla Revels
• Revolution Incorporated
• Revolution USA Group Incorporated
• Jaime Reyes Gonzalez, MA
• Alexandria Reyes-Smith, RD
• Audrey Rose Pagtalunan Reyes, PT, DPT
• Demira Reyes

• Physical Therapist in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; 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.