Revitalize Chiropractic

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

REVITALIZE CHIROPRACTIC

Practice address

600 E Bailey Boswell Rd Ste 150
Ft Worth, TX 76131-3573

Phone

(817) 482-3388

Fax

(817) 704-0393

NPI assigned

Nov 13, 2024

Organization subpart

No

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

Authorized official

Name

Juliet Ekeiwu

Title

Credentialing

Phone

(404) 680-1004

Specialties & licenses 1

Addresses

Other names 1

• Revitalize Chiropractic, PLLC Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 2

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

• Thomas Russell Barton, DC

  • Chiropractor
  • Ft Worth, TX
  • NPI 1376367631
  Medicare reassignment Care Compare group NPD
• Megan Peterson, DC

  • Chiropractor
  • Ft Worth, TX
  • NPI 1013731371
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1731456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731456000000",
    "number": "1982428249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E BAILEY BOSWELL RD STE 150",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761313573",
            "telephone_number": "817-482-3388",
            "fax_number": "817-704-0393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E BAILEY BOSWELL RD STE 150",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761313573",
            "telephone_number": "817-482-3388",
            "fax_number": "817-704-0393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVITALIZE CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-13",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A",
        "authorized_official_last_name": "EKEIWU",
        "authorized_official_first_name": "JULIET",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "404-680-1004"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revitalize Chiropractic, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Krista L Rettig, CPNP
• Return 2 PLLC
• Kristen Reuter, LCSW
• Ann Revard, LCSW
• Jaime Delynn Revilla
• Revive Chiropractic LLC
• Reviving Hope Christian Counseling PLLC
• Monika Lucille Revlett, LPN
• Elise Hull Rex, M.D.
• Angela Diane Rexwinkle, M.S.

• Chiropractor in Ft Worth, TX
• Providers in Ft Worth, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.