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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: October 25, 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, 2028 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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Revan Health Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Revan Health LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Chris Sholer, MD
Nephrology
NPI 1326047226
4334 NW EXPRESSWAY STE 106
Oklahoma City, OK 73116
(405) 842-8298
✔ PECOS✔ Accepts Medicare0.9 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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, 2028
CLIA Number37D2191104
Laboratory TypePhysician Office
Certificate Effective DateAugust 24, 2026
Certificate Expiration DateAugust 23, 2028
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.

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.

Is Revan Health LLC enrolled in Medicare?

Yes. Revan Health LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Revan Health LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nephrology) reassigns their Medicare billing to Revan Health LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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, 2028. 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.