REVIVAL PAIN MANAGEMENT, INC (NPI# 1164729257) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164729257 |
| Entity Type | Organization |
| Organization Name | REVIVAL PAIN MANAGEMENT, INC |
| Practice Address |
110 Dutchman Ct Elkin NC 28621-2237 |
| Mailing Address |
Po Box 100 Jackson NJ 08527-0100 |
| Practice Telephone | 3368355337 |
| Mailing Telephone | 7329285346 |
| Enumeration Date | 2011-02-25 |
| Last Update Date | 2011-02-25 |
| Authorized Official Name | EMIDIO NOVEMBRE (OWNER) |
| Authorized Official Telephone | 3368355300 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
200201393 | NC | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194023051 | Revival Pain Management, Inc | Family Medicine | 110 Dutchman Ct, Elkin, NC 28621-2237 | 2011-03-02 |
| Street Address |
110 DUTCHMAN CT |
| City | ELKIN |
| State | NC |
| Zip Code | 28621-2237 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578543997 | Donna Kay Davis | Nurse Practitioner | 110 Dutchman Ct, Elkin, NC 28621-2237 | 2006-01-20 |
| 1114416971 | Matthew Jon Slawter | Nurse Practitioner | 110 Dutchman Ct, Elkin, NC 28621-2237 | 2018-05-08 |
| 1205376688 | Northern Hospital of Surry County | Pain Medicine | 110 Dutchman Ct, Elkin, NC 28621-2237 | 2017-03-03 |
| 1588099022 | Northern Hospital of Surry County | Pharmacy | 110 Dutchman Ct, Elkin, NC 28621-2237 | 2013-09-03 |
| 1225379910 | Surry Regional Health Services Inc. | Anesthesiology | 110 Dutchman Ct, Elkin, NC 28621-2237 | 2013-03-06 |
| 1194023051 | Revival Pain Management, Inc | Family Medicine | 110 Dutchman Ct, Elkin, NC 28621-2237 | 2011-03-02 |
| 1265514194 | Ben Alfred Raines | Family Medicine | 110 Dutchman Ct, Elkin, NC 28621 | 2006-10-19 |
| 1801813712 | Revival Pain Management Inc | Anesthesiology | 110 Dutchman Ct, Elkin, NC 28621-2237 | 2006-07-16 |
| 1205897956 | Richard James Stork | Pain Medicine | 110 Dutchman Ct, Elkin, NC 28621-2237 | 2006-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013553692 | Carenet, Inc. | Counselor | 1288 C.b. Eller School Road, Elkin, NC 28621 | 2019-11-19 |
| 1386104776 | North Bridge Physio and Sports Performance | Clinic/Center | 1605 North Bridge Street, Elkin, NC 28621 | 2019-03-21 |
| 1609389238 | Rebecca Anne Dumas | Physical Therapist | 145 Valleybrook Dr, Elkin, NC 28621 | 2017-11-06 |
| 1922547744 | Lori Barker | Clinical Nurse Specialist | 124, Samaritan's Ridge Road, Elkin, NC 28621 | 2017-02-13 |
| 1205061256 | Hugh Chatham Memorial Hospital, Inc | Internal Medicine | 520 Chatham Medical Park, Elkin, NC 28621 | 2009-05-20 |
| 1093909236 | Elkin Obstetrics and Gynecology, Pllc | Obstetrics & Gynecology | 101 A Eldon Parks Dr., Elkin, NC 28621 | 2007-08-30 |
| 1497956205 | Nayana Abrol | Internal Medicine | 180 Parkwood Drive, Hugh Chatham Memorial Hospital, Elkin, NC 28621 | 2007-05-30 |
| 1104950765 | Dgis Elkin Inc Dba Chatham Nursing and Rehabilitation | Skilled Nursing Facility | 700 Johnson Ridge Road, Elkin, NC 28621 | 2007-03-15 |
| 1093860777 | Carolina Select Home Care, LLC. | Home Health | 948-b Johnson Ridge Rd., Elkin, NC 28621 | 2007-01-24 |
| 1922160761 | Piedmont Department of Urology, Pllc | Urology | 350 Johnson Ridge Medical Park, Elkin, NC 28621 | 2006-12-15 |
| Find all providers in zip 28621 | ||||
| Taxonomy Code | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306317011 | United Spine & Pain PC | Pain Medicine | 855 Bradley St Ste A, Concord, NC 28025-2979 | 2018-12-07 |
| 1144604273 | Justis Group of Edenton | Pain Medicine | 905 Cherry St, North Wilkesboro, NC 28659-4251 | 2015-07-18 |
| 1578968079 | Carolinas Center for Advanced Management of Pain | Pain Medicine | 2569 Pembroke Rd, Gastonia, NC 28054-4712 | 2014-10-27 |
| 1255351110 | Scott Richard Johnston | Pain Medicine | 250 Huff Dr, Jacksonville, NC 28546-7369 | 2006-07-20 |
| 1558366385 | Sunil K Arora | Pain Medicine | 1602 Physicians Dr, Suite 103, Wilmington, NC 28401-7363 | 2005-06-17 |
| 1528063542 | Center for Pain Management Pllc | Pain Medicine | 1602 Physicians Dr Ste 103, Wilmington, NC 28401-7350 | 2005-06-16 |
| 1992310502 | Southeastern Pain and Wellness, Pllc | Pain Medicine | 402 W King St, King, NC 27021-9170 | 2020-09-10 |
| 1710592399 | Triangle Pain Institute | Pain Medicine | 2605 Blue Ridge Rd Ste 330, Raleigh, NC 27607-6475 | 2020-09-10 |
| 1144863358 | Envision Pain Management Pllc | Pain Medicine | 107 Haywood Park Dr, Clyde, NC 28721-4405 | 2019-10-21 |
| 1518438811 | Medical Innovations Concepts, P.C. | Pain Medicine | 294 N Nc 16 Business Hwy Ste B, Denver, NC 28037-8741 | 2018-12-12 |
| 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.