REVITAL LLC (NPI# 1386007763) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386007763 |
| Entity Type | Organization |
| Organization Name | REVITAL LLC |
| Practice Address |
124 Chesterfiled Towne Ctr Chesterfield MO 63005-1230 |
| Practice Telephone | 3142542400 |
| Practice Fax Number | 6369339177 |
| Mailing Telephone | 3142542400 |
| Mailing Fax Number | 6369339177 |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2016-04-01 |
| Authorized Official Name | KEVIN MEURET (OWNER/CEO) |
| Authorized Official Telephone | 3142542420 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518320589 | Revital LLC | Internal Medicine | 101 Main St, Suite 2300 B, Festus, MO 63028-1977 | 2016-03-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | REVITAL LLC | 2981-2991 Hempstead Tpke, #1043, Levittown, Ny 11756 |
| Street Address |
124 CHESTERFILED TOWNE CTR |
| City | CHESTERFIELD |
| State | MO |
| Zip Code | 63005-1230 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063901254 | Ryan Hewkin | Chiropractor | 17684 Chesterfield Airport Road, Chesterfield, MO 63005 | 2018-05-03 |
| 1093224487 | All Family Matters, LLC | In Home Supportive Care | 100 Chesterfield Business Pkwy Ste 200, Chesterfield, MO 63005 | 2017-09-28 |
| 1437681293 | Emily Therese Harpel | Pharmacist | 691 Trade Center Blvd, Chesterfield, MO 63005 | 2017-03-31 |
| 1831543826 | Leslie Noel Chanasue | Family Medicine | 17701 Edison Ave Ste 101, Chesterfield, MO 63005 | 2016-04-16 |
| 1497112874 | Jordan Kimler | Nurse Practitioner | 124 Chesterfield Towne Ctr, Chesterfield, MO 63005 | 2016-01-15 |
| 1265850556 | Richard George Rougeau | General Practice | 17679 Wildridge Drive, Wildwood, MO 63005 | 2014-04-03 |
| 1679912554 | Ceara M Barmeier | Physician Assistant | 17300 N Outer 40 Rd #101, Chesterfield, MO 63005 | 2013-06-24 |
| 1265794911 | Regeneration Orthopedics, LLC | Anesthesiology | 6 Mcbride & Son Center Dr., Ste 204, Chesterfield, MO 63005 | 2012-06-08 |
| 1528334984 | Syed Tanveer Haider | Radiologic Technologist | 16502 Barrister Lane, Chesterfield, MO 63005 | 2012-03-29 |
| 1144591041 | Sensible Dental - Chesterfield | Dentist | 100 Thf Blvd., Chesterfield, MO 63005 | 2012-01-24 |
| Find all providers in zip 63005 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225658040 | West County Internal Medicine LLC | Internal Medicine | 16216 Baxter Rd Ste 320, Chesterfield, MO 63017-4778 | 2020-04-22 |
| 1912427246 | Rajat Shailly | Internal Medicine | 222 S Woods Mill Road, 760 North, Chesterfield, MO 63017 | 2017-06-27 |
| 1730561069 | Daniela Blum Morales | Internal Medicine | 222 S Woods Mill Rd Ste 760n, Chesterfield, MO 63017-3654 | 2015-06-23 |
| 1770985970 | Elite Medical Consulting, LLC | Internal Medicine | 1044 Nooning Tree Dr, Chesterfield, MO 63017-2478 | 2014-09-18 |
| 1427499235 | Edward Martin Aten | Internal Medicine | 1422 Elbridge Payne Rd, Chesterfield, MO 63017-8521 | 2013-07-09 |
| 1992063515 | Nirmol Mary Philip | Internal Medicine | 222 S Woods Mill Rd Ste 750, Chesterfield, MO 63017-3625 | 2012-05-02 |
| 1861762668 | Woods Mill Medical Associates, LLC | Internal Medicine | 224 S Woods Mill Rd Ste 435s, Chesterfield, MO 63017-3408 | 2012-01-10 |
| 1871806836 | Max M. Inman | Internal Medicine | 314 Travertine Lane, Chesterfield, MO 63017 | 2010-07-20 |
| 1922237130 | Ji Huang | Internal Medicine | 224 S Woods Mill Rd Ste 370s, Chesterfield, MO 63017-3603 | 2009-07-09 |
| 1023268588 | Meghashyam Jayateerth Koti | Internal Medicine | 15740 S Outer 40 Rd # C, Chesterfield, MO 63017-2004 | 2008-09-22 |
| Find all providers in CHESTERFIELD | ||||
| City | CHESTERFIELD |
| Zip Code | 63005 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.