OrganizationActive
Revolution Health & Wellness Clinic PLLC
NPI 1649515446 · Family Medicine Physician · Glenpool, OK
Provider details
- NPI number
- 1649515446
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Chad Edwards, Physician/Owner(918) 935-3636
- License
- 4353 (OK)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(78/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
12142 S Yukon Ave
Glenpool, OK 74033-6621
Phone: (918) 935-3636
Fax: (918) 935-3635
Street-level locationGet directions
Mailing address
2865 E Skelly Dr Ste 300
Tulsa, OK 74105-6233
Registry dates
- Enumerated
- 2012-12-05
- Last updated
- 2021-02-22
- Certified
- 2021-02-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.