REVOLUTION HEALTH & WELLNESS CLINIC PLLC
NPI 1649515446
Family Medicine in Glenpool, OK

Q: What is Revolution Health & Wellness Clinic PLLC's specialty?

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

Active since December 05, 2012CLIA 37D2052346 · Waiver

12142 S YUKON AVE, GLENPOOL, OK 74033(918) 935-3636(918) 935-3635 Get Directions Write a Review

NPPES record last updated: February 22, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Revolution Health & Wellness Clinic Pllc NPPES

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

REVOLUTION HEALTH & WELLNESS CLINIC PLLC (NPI 1649515446) is a healthcare organization registered as a family medicine in Glenpool, Oklahoma and active in the NPI registry since December 2012. The organization holds a CLIA Waiver certificate valid through January 8, 2027 and lists Chad Preston Edwards, Physician/owner, as its authorized official.

NPPES Registry Identity

NPI1649515446

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameREVOLUTION HEALTH & WELLNESS CLINIC PLLC

Location Address12142 S YUKON AVEGlenpool, OK 74033-6621

Mailing Address2865 E Skelly Dr Ste 300Tulsa, OK 74105-6233 · (918) 935-3636 · Fax (918) 935-3635

Phone(918) 935-3636

Fax(918) 935-3635

Organization SubpartNo

Authorized OfficialChad Preston EdwardsPhysician/owner · (918) 935-3636

Enumeration DateDecember 5, 2012

Last NPPES UpdateFebruary 22, 2021

NPPES CertifiedFebruary 22, 2021

✔ NPI 1649515446 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in OK · 4353

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.

12142 S YUKON AVE, Glenpool, OK 74033

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Other Identifiers 1

Other1790833481OK · Personal Npi Number

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 37D2052346

Revolution Health And Wellness · Sapulpa, OK

Active · expires Jan 8, 2027

CLIA Number37D2052346

Laboratory TypePhysician Office

Certificate Effective DateJanuary 9, 2025

Certificate Expiration DateJanuary 8, 2027

Laboratory DirectorChad P. Edwards

Laboratory Phone(918) 935-3636

Laboratory LocationRevolution Health And Wellness1008 W Taft, Sapulpa, OK 74066

CLIA data matches this NPI record on: Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 9

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

DEBBIE GLADD FOLEY D.O.

Internal Medicine (Rheumatology)