JONATHAN W REVELS (NPI# 1750674164) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750674164 |
| Entity Type | Individual |
| Full Name | JONATHAN W REVELS |
| Credential | DO |
| Practice Address |
2211 Lomas Blvd Ne Albuquerque NM 87106-2719 |
| Mailing Address |
Po Box 50095 Seattle WA 98145-5095 |
| Practice Telephone | 5052721476 |
| Mailing Telephone | 2065205700 |
| Enumeration Date | 2011-05-17 |
| Last Update Date | 2019-02-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
A-2207-19 | NM | Allopathic & Osteopathic Physicians |
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
OP60730003 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1750674164 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1959 Ne Pacific St, Seattle, WA 98195 | 2065987200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932559911 | Jonathan Revels | Counselor | 117 W Medical Ct, Marion, NC 28752-5590 | 2016-06-21 |
| Street Address |
2211 LOMAS BLVD NE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87106-2719 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912902016 | Gloria Doherty | Nurse Practitioner | 2211 Lomas Blvd Ne, Albuquerque, NM 87106-2719 | 2005-06-15 |
| 1427659127 | Letitia Tomaszewski | Student in an Organized Health Care Education/Training Program | 2211 Lomas Blvd Ne, Albuquerque, NM 87106-2719 | 2020-11-08 |
| 1467053116 | Luis Aaron Trillo | Student in an Organized Health Care Education/Training Program | 2211 Lomas Blvd Ne, Albuquerque, NM 87106-2719 | 2020-11-07 |
| 1215538095 | Rafael Alejandro Fernandez-mancha | Student in an Organized Health Care Education/Training Program | 2211 Lomas Blvd Ne, Albuquerque, NM 87106-2719 | 2020-11-06 |
| 1144821950 | Jaylee Caruso | Student in an Organized Health Care Education/Training Program | 2211 Lomas Blvd Ne, Albuquerque, NM 87106-2719 | 2020-11-06 |
| 1508467648 | Christine Hsu Teng | Student in an Organized Health Care Education/Training Program | 2211 Lomas Blvd Ne, Albuquerque, NM 87106-2719 | 2020-11-05 |
| 1649871641 | Martin Jurado | Student in an Organized Health Care Education/Training Program | 2211 Lomas Blvd Ne, Albuquerque, NM 87106-2719 | 2020-11-05 |
| 1912508284 | Joshua Marquez | Student in an Organized Health Care Education/Training Program | 2211 Lomas Blvd Ne, Albuquerque, NM 87106-2719 | 2020-11-04 |
| 1609477850 | Jessica Elena Larsen | Student in an Organized Health Care Education/Training Program | 2211 Lomas Blvd Ne, Albuquerque, NM 87106-2719 | 2020-11-04 |
| 1619578879 | Kevin A Martinez | Student in an Organized Health Care Education/Training Program | 2211 Lomas Blvd Ne, Albuquerque, NM 87106-2719 | 2020-11-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629679808 | Jorge Licano | Student in an Organized Health Care Education/Training Program | Unmh Hospital 2211 Lomas Blvd Ne, Albuquerque, NM 87106 | 2020-11-04 |
| 1730780032 | Joseph Sanchez | Student in an Organized Health Care Education/Training Program | (unmh Hospital 2211 Lomas Blvd Ne, Albuquerque, NM 87106 | 2020-11-03 |
| 1336746205 | Evan Laub | Pharmacist | 2950 Central Ave. Sw, Albuquerque, NM 87106 | 2020-10-05 |
| 1487203154 | Theresa Martinez | Technician | 5680 Avedon Dr. Se, Albuquerque, NM 87106 | 2019-09-05 |
| 1205300647 | Louis Mayer II | Specialist/Technologist | 1414 University Blvd Tow Diehm Athletic Facility, Albuquerque, NM 87106 | 2019-01-18 |
| 1235633355 | Terrena Grace Vigil Brady | Occupational Therapist | 1001 Yale Blvd, Albuquerque, NM 87106 | 2018-03-22 |
| 1205355195 | Yaritza Ruiz | Specialist/Technologist | 1200 Avenida Cesar Chavez, 231d, Albuquerque, NM 87106 | 2017-09-12 |
| 1457873382 | Cynthia Bluhm | Registered Nurse | 7600 Cedar St Se Ste 7600, Albuquerque, NM 87106 | 2017-07-12 |
| 1295265882 | Hallie Chancellor | Behavior Technician | 1801 Gibson Blvd Se Apt 1046, Albuquerque, NM 87106 | 2017-06-15 |
| 1780111757 | Jiana Hook | Physical Medicine & Rehabilitation | 1414 University Blvd. Se, Albuquerque, NM 87106 | 2017-05-22 |
| Find all providers in zip 87106 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124658299 | City Mobile Ultrasound, LLC | Radiology | 524 Richmond Dr Se, Albuquerque, NM 87106-2328 | 2020-01-17 |
| 1013407964 | Erika Jane Starks | Radiology | Radiology Msc 10-5530 1 University of New Mexico, Albuquerque, NM 87131-5040 | 2018-05-16 |
| 1700229523 | Martha F Terrazas | Radiology | Msc 10 5530 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2013-04-11 |
| 1922341585 | Katherine Nicole Epstein | Radiology | Msc10 5530 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2013-04-02 |
| 1962745869 | Joshua Eric Rider | Radiology | Unmh, 2211 Lomas Blvd Ne, Albuquerque, NM 87106 | 2013-03-29 |
| 1346506904 | Andrew Bruner | Radiology | Msc 10-5550 1, University of New Mexico, Albuquerque, NM 87131 | 2012-04-09 |
| 1942576145 | Douglas James Alden | Radiology | 373 Big Horn Ridge Dr Ne, Albuquerque, NM 87122-1424 | 2012-04-02 |
| 1689947921 | Robert Johnson | Radiology | 804 Piedra Vista Rd Ne, Albuquerque, NM 87123-1954 | 2012-02-16 |
| 1386936623 | Matthew Stevens Myers | Radiology | Graduate Medical Education Msc 116093, 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2011-05-04 |
| 1346530409 | Amirkasra Mojtahed | Radiology | 4352 Altura Mesa Ln Ne, Albuquerque, NM 87110-5059 | 2011-04-11 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87106 |
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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.