| Revan Health Llc | |
|
5601 Nw 72nd St Ste 142 Warr Acres OK 73132-5924 | |
| (405) 896-7975 | |
| (866) 473-0490 |
| Full Name | Revan Health Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 5601 Nw 72nd St Ste 142, Warr Acres, Oklahoma |
| Authorized Official Name and Position | Justin Evans (CEO) |
| Authorized Official Contact | 4058967975 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Revan Health Llc 5601 Nw 72nd St Ste 242 Warr Acres OK 73132-5923 Ph: (405) 896-7975 | Revan Health Llc 5601 Nw 72nd St Ste 142 Warr Acres OK 73132-5924 Ph: (405) 896-7975 |
| NPI Number | 1114540689 |
|---|---|
| Provider Enumeration Date | 05/19/2020 |
| Last Update Date | 02/03/2021 |
| Medicare PECOS PAC ID | 6305266214 |
|---|---|
| Medicare Enrollment ID | O20201014003485 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114540689 | NPI | - | NPPES |
| 200917850A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Chris Sholer |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1326047226 PECOS PAC ID: 3870520471 Enrollment ID: I20060221000188 |
| Provider Name | Bridget Ann Van Treese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821508037 PECOS PAC ID: 9830450360 Enrollment ID: I20180226001866 |
| Provider Name | Jewelle M Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891354973 PECOS PAC ID: 6305177304 Enrollment ID: I20191004002459 |
Grand Prairie Pediatrics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7301 N Comanche Ave, Warr Acres, OK 73132 Phone: 405-721-8090 Fax: 405-722-8529 | |
Paragon Geriatric Associates, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5601 Nw 72nd St Ste 245, Warr Acres, OK 73132 Phone: 405-400-7557 Fax: 844-868-8139 | |
Northwest Family Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7301 N Comanche Ave, Warr Acres, OK 73132 Phone: 405-728-2100 Fax: 405-728-2244 |