REVIVE PAIN & SPINE CENTER INC (NPI# 1063991685) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063991685 |
| Entity Type | Organization |
| Organization Name | REVIVE PAIN & SPINE CENTER INC |
| Practice Address |
1321 College St Ste D Woodland CA 95695 |
| Mailing Address |
1321 College St Ste D Woodland CA 95695-4706 |
| Practice Telephone | 5306656705 |
| Mailing Telephone | 5306656705 |
| Enumeration Date | 2018-08-14 |
| Last Update Date | 2018-08-28 |
| Authorized Official Name | AKBAR KHAN (PRESIDENT OF CORPORATION) |
| Authorized Official Telephone | 5306656705 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
20A13486 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | INDIVIDUAL NPI | 1528383833 | 01 |
| Street Address |
1321 COLLEGE ST STE D |
| City | WOODLAND |
| State | CA |
| Zip Code | 95695 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114008653 | Mark Renard Fisher | Physical Therapist | 1321 College St Ste D, Woodland, CA 95695-4706 | 2006-10-18 |
| 1558484303 | Fisher Physical Therapy | Physical Therapist | 1321 College St Ste D, Woodland, CA 95695-4706 | 2007-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346851144 | Tariro Angela Sawaya | Student in an Organized Health Care Education/Training Program | 445 1st Street, Woodland, CA 95695 | 2020-08-14 |
| 1093277683 | Christie Lynne Vice | Marriage & Family Therapist | 255 W Court St Ste D, Woodland, CA 95695 | 2019-04-02 |
| 1912479437 | Phillips Scoliosis Center | Chiropractor | 375 W Main St., Ste C-1, Woodland, CA 95695 | 2018-12-21 |
| 1568947042 | Nikhil Sibal | Dentist | Woodland Family Dental, 58 W Court Street, Woodland, CA 95695 | 2018-10-01 |
| 1659860849 | Savannah Ellizabeth Lindley | Behavior Technician | 260 West Main St, Woodland, CA 95695 | 2018-05-03 |
| 1982133344 | Brittanie Ann Akey | Behavior Technician | 1102 Gary Way, Woodland, CA 95695 | 2017-06-08 |
| 1083163604 | Arthur Hernandez | Nurse Practitioner | 215 West Beamer Street, Woodland, CA 95695 | 2016-09-23 |
| 1386191856 | Kelly Lee | Registered Nurse | 25 N. Cottonwood St., Adult and Aging Branch, Yolo County Hhsa, Woodland, CA 95695 | 2016-09-01 |
| 1730634486 | Ida Nilanthi Lonnerdal | Marriage & Family Therapist | 455 First Street, Woodland, CA 95695 | 2016-08-23 |
| 1912365974 | Yaretzi Counseling and Consulting LLC | Social Worker | 327 College St Ste 105, Woodland, CA 95695 | 2016-02-05 |
| Find all providers in zip 95695 | ||||
| Taxonomy Code | 2081P2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pain Medicine |
| A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528383833 | Akbar Khan | Physical Medicine & Rehabilitation | 1321 Cottonwood St, Woodland, CA 95695-5131 | 2010-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881295608 | San Diego Comprehensive Pain Management Center, Inc | Physical Medicine & Rehabilitation | 1575 W Main St, El Centro, CA 92243-2211 | 2020-11-06 |
| 1760013536 | Aveva Medical Aesthetics Inc. | Physical Medicine & Rehabilitation | 4702 W 1st St Ste C, Santa Ana, CA 92703-3100 | 2020-01-30 |
| 1902445620 | Irina L Melnik, Md Professional Corporation | Physical Medicine & Rehabilitation | 655 Redwood Hwy Frontage Rd Ste 203, Mill Valley, CA 94941-3025 | 2019-12-27 |
| 1124669544 | Algos Inc., A Medical Corporation | Physical Medicine & Rehabilitation | 26357 Mcbean Pkwy Ste 210, Santa Clarita, CA 91355-4497 | 2019-10-07 |
| 1174084578 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 802 Iowa Ave, Los Banos, CA 93635-3450 | 2019-03-28 |
| 1083175483 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 777 S Ham Ln Ste G, Lodi, CA 95242-3593 | 2019-03-28 |
| 1679031611 | Jesus H. Lao Md Inc | Physical Medicine & Rehabilitation | 6699 Alvarado Rd Ste 2304, San Diego, CA 92120-5241 | 2019-03-08 |
| 1316404262 | Advanced Pain Diagnostic & Solutions, Inc. | Physical Medicine & Rehabilitation | 1921 Sycamore Ln, Davis, CA 95616-0844 | 2019-02-27 |
| 1689157059 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 801 E Chapel St Ste 6, Santa Maria, CA 93454-4607 | 2018-09-12 |
| 1588147094 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 803 Coffee Rd Ste 11, Modesto, CA 95355-4244 | 2018-09-11 |
| Find all providers with the same taxonomy | ||||
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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.