ELIZABETH B REVILLA (NPI# 1265631436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1265631436 |
Entity Type | Individual |
Full Name | ELIZABETH B REVILLA |
Credential | MS, RD, LD, CSP |
Practice Address |
1547 Clifton Rd Ne Atlanta GA 30322-4008 |
Practice Telephone | 4047851784 |
Practice Fax Number | 4047274828 |
Mailing Telephone | 4047851784 |
Mailing Fax Number | 4047274828 |
Enumeration Date | 2007-07-17 |
Last Update Date | 2007-07-17 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 133VN1004X |
Dietitian, Registered Specialization: Nutrition, Pediatric |
LD002723 | GA | Dietary & Nutritional Service Providers |
Street Address |
1547 CLIFTON RD NE |
City | ATLANTA |
State | GA |
Zip Code | 30322-4008 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952415184 | Daniel Matthew Torrez | Pediatrics | 1547 Clifton Rd Ne, Atlanta, GA 30322-4008 | 2006-08-17 |
1689020612 | Jeffrey Okonye | Pediatrics | 1547 Clifton Rd Ne, Atlanta, GA 30322-7593 | 2016-05-09 |
1861806952 | Susan Mcmanus | Clinical Neuropsychologist | 1547 Clifton Rd Ne, Suite 200, Atlanta, GA 30322-4008 | 2014-06-17 |
1598070112 | Jeannette Marie Peabody | Registered Nurse | 1547 Clifton Rd Ne, Atlanta, GA 30322-4008 | 2010-08-09 |
1184760548 | Stephanie Pendley | Nurse Practitioner | 1547 Clifton Rd Ne, Atlanta, GA 30322-4008 | 2007-01-30 |
1427090752 | Daniel B Caplan | Pediatrics | 1547 Clifton Rd Ne, 2nd Floor, Atlanta, GA 30322-4008 | 2006-06-12 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700445830 | Justin Gill | Student in an Organized Health Care Education/Training Program | 1365 Clifton Rd Ne, Clinic B - Suite B6100, Atlanta, GA 30322 | 2019-06-12 |
1891354510 | Gwendolyn Gisiner Gunn | Genetic Counselor, MS | Emory Genetics Clinic, 1365 Clifton Road Ne, Atlanta, GA 30322 | 2019-06-06 |
1144710567 | Lisa Cathy-ann Akosa | Registered Nurse | 1365 Cifton Road Ne, Atlanta, GA 30322 | 2018-05-10 |
1083118004 | Jessica Milian Keilson | Student in an Organized Health Care Education/Training Program | 1364 Clifton Road Ne, Suite H100, Emory University Hospital Office of Surgical Education, Atlanta, GA 30322 | 2018-03-23 |
1568982684 | Jennifer Bilko | Dietitian, Registered | 1365 Clifton Rd., Bldg A, 1st Floor, Suite 1450, Atlanta, GA 30322 | 2017-06-20 |
1134652258 | Kassahun Bilcha | Student in an Organized Health Care Education/Training Program | 1525 Clifton Rd Ne Ste 100, Atlanta, GA 30322 | 2017-04-05 |
1356872246 | Tova Rogers | Dermatology | 1525 Clifton Road Suite 105, Atlanta, GA 30322 | 2017-03-23 |
1194271445 | Dina Amin | Dentist | 1365 Clifton,building B, Oral and Maxillofacial Surgery, Suite 2300, Atlanta, GA 30322 | 2016-08-28 |
1427404904 | Rita Kaur Kuwahara | Student in an Organized Health Care Education/Training Program | 100 Woodruff Circle, Suite 327, Atlanta, GA 30322 | 2016-05-13 |
1891176251 | Octav Cristea | Transplant Surgery | 1365 Clifton Road Northeast, Building B, 6th Floor, Atlanta, GA 30322 | 2015-06-11 |
Find all providers in zip 30322 |
Taxonomy Code | 133VN1004X |
Grouping | Dietary & Nutritional Service Providers |
Classification | Dietitian, Registered |
Specialization | Nutrition, Pediatric |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629603691 | Meredith Leigh Johnson | Dietitian, Registered | 1400 Tullie Rd Ne # 8221b, Atlanta, GA 30329-2309 | 2020-03-10 |
1144862749 | Victoria Baird | Dietitian, Registered | 1400 Tullie Rd Ne, Atlanta, GA 30329-2309 | 2019-10-15 |
1659855765 | Lydia Delbridge White | Dietitian, Registered | 1920 Briarcliff Rd Ne, Atlanta, GA 30329-4010 | 2018-09-25 |
1902264153 | Nicole Mcgee Smith | Dietitian, Registered | 1920 Briarcliff Rd Ne, Atlanta, GA 30329-4010 | 2016-02-03 |
1447592985 | Tiffany Lachelle Avera | Dietitian, Registered | 80 Jesse Hill Jr Dr Se, Atlanta, GA 30303-3031 | 2013-03-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811546211 | April Lynn Dehetre Perkins | Dietitian, Registered | 4 N Quail Xing, Savannah, GA 31419-1244 | 2019-09-09 |
1407373905 | Chelsea Hrovat | Dietitian, Registered | 1690 Stone Village Ln Nw Ste 322, Kennesaw, GA 30152-7778 | 2017-08-25 |
1285058446 | Jeanne Baker Mcdaniel | Dietitian, Registered | 289 Dartmoor Cir, Sandy Springs, GA 30328-1902 | 2014-02-09 |
1992004519 | Karen Alicia Baldree | Dietitian, Registered | 122 Oakwood Ct, Tifton, GA 31793-5755 | 2011-03-22 |
1720156110 | Laura Lee Davis | Dietitian, Registered | 1640 Powers Ferry Road, Suite 100, Building 9, Marietta, GA 30067-5491 | 2006-12-01 |
1770104283 | Sierra Jacquelynn Wineinger | Dietitian, Registered | 1446 Harper St, Augusta, GA 30912-0012 | 2020-05-06 |
1053866970 | Nourishing Nutrition Consulting LLC | Dietitian, Registered | 14 Eastbrook Bnd, Suite 212, Peachtree City, GA 30269-1530 | 2016-08-20 |
1881039030 | Kristen Middleton | Dietitian, Registered | 1446 Harper St, Bp-3252, Augusta, GA 30912-0012 | 2013-05-01 |
1235475765 | Brittany Elizabeth Lightsey | Dietitian, Registered | 4700 Waters Ave, Savannah, GA 31404-6220 | 2013-01-03 |
1538332663 | Mary Lauren Whiteside | Dietitian, Registered | 4700 Waters Ave, Food & Nutrition Services, Savannah, GA 31404-6220 | 2008-04-09 |
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.