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REVAN HEALTH LLC
NPI 1114540689
Family Medicine in Warr Acres, OK

Active since May 19, 2020CLIA 37D2191104 · Waiver
5601 NW 72ND ST STE 142, WARR ACRES, OK 73132(405) 896-7975(866) 473-0490 Get Directions Write a Review

NPPES record last updated: February 3, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 3, 2021, May 19, 2020 (2 updates tracked since 2020).

About Revan Health Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

REVAN HEALTH LLC (NPI 1114540689) is a healthcare organization registered as a family medicine in Warr Acres, Oklahoma and active in the NPI registry since May 2020. The organization holds a CLIA Waiver certificate valid through August 23, 2026 and lists Justin Evans, Ceo, as its authorized official.

NPPES Registry Identity

NPI1114540689
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameREVAN HEALTH LLC
Location Address5601 NW 72ND ST STE 142Warr Acres, OK 73132-5924
Mailing Address5601 Nw 72nd St Ste 242Warr Acres, OK 73132-5923 · (405) 896-7975 · Fax (866) 473-0490
Phone(405) 896-7975
Fax(866) 473-0490
Organization SubpartNo
Authorized OfficialJustin EvansCeo · (405) 896-7975
Enumeration DateMay 19, 2020
Last NPPES UpdateFebruary 3, 20212 updates tracked since enumeration
NPPES CertifiedFebruary 3, 2021
✔ NPI 1114540689 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
5601 NW 72ND ST STE 142, Warr Acres, OK 73132
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Other Identifiers 1

Medicaid200917850AOK

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 37D2191104

Revan Health · Warr Acres, OK
Active · expires Aug 23, 2026
CLIA Number37D2191104
Laboratory TypePhysician Office
Certificate Effective DateAugust 24, 2024
Certificate Expiration DateAugust 23, 2026
Laboratory DirectorJason Revel
Laboratory Phone(405) 896-7975
Laboratory LocationRevan Health5601 NW 72nd St, Ste 142, Warr Acres, OK 73132
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

REVAN INC
Pharmacy
5601 NW 72ND ST STE 142
WARR ACRES, OK 73132
Oklahoma County (888) 773-8267
DR. JASON ROBERT REVEL PHARM.D.
Pharmacist
5601 NW 72ND ST STE 142
WARR ACRES, OK 73132
Oklahoma County (888) 773-8266
DR. STEPHEN MARC TAYLOR D.D.S.
Dentist (General Practice)
5601 NW 72ND ST STE 142
WARR ACRES, OK 73132
Oklahoma County (405) 722-4400

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Revan Health LLC's NPI number?

The NPI number for Revan Health LLC is 1114540689. It was assigned to this organization in the NPPES registry on May 19, 2020.

Where is Revan Health LLC located?

Revan Health LLC is located at 5601 NW 72nd St Ste 142, Warr Acres, OK 73132. The listed phone number is (405) 896-7975.

What is Revan Health LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Revan Health LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 37D2191104) is associated with this NPI, valid through August 23, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Revan Health LLC was last updated on February 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.