REVIVE MEDICAL CENTER, LLC (NPI# 1750801205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750801205 |
| Entity Type | Organization |
| Organization Name | REVIVE MEDICAL CENTER, LLC |
| Practice Address |
753 Old Norcross Rd Ste A Lawrenceville GA 30046-4312 |
| Practice Telephone | (770) 545-8888 |
| Practice Fax Number | 7705458889 |
| Mailing Telephone | 7705458888 |
| Mailing Fax Number | 7705458889 |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2019-05-13 |
| Authorized Official Name | MICHAEL D SCHULMAN (OWNER) |
| Authorized Official Telephone | 7705458888 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | GA | Chiropractic Providers | |
| Y | 207R00000X | Internal Medicine | GA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Apex Integrated Medical | Doing Business As Name - Organization |
| Street Address |
753 OLD NORCROSS RD STE A |
| City | LAWRENCEVILLE |
| State | GA |
| Zip Code | 30046-4312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063023174 | Alpha & Omega Hearing Centers | Hearing Instrument Specialist | Alpha & Omega Hearing Centers, 250 Langley Drive, Suite 1106, Lawrenceville, GA 30046 | 2020-08-12 |
| 1285259846 | Mesun Health Services, Inc | Clinical Nurse Specialist | 88 Johnson Rd Building # 1-b, Lawrenceville, GA 30046 | 2020-06-10 |
| 1215550264 | Mesun Health Services, Inc | Skilled Nursing Facility | 88 Johnson Rd. Building #2, Lawrenceville, GA 30046 | 2020-05-26 |
| 1306499785 | Bryan Acosta | Chiropractor | 471 Scenic Hwy South, Lawrenceville, GA 30046 | 2019-07-24 |
| 1205308616 | Belle Lumiere Cosmetics LLC | Dermatology | 753 Old Norcross Road, Lawrenceville, GA 30046 | 2018-12-24 |
| 1548730179 | Alexis Nicole Robinson | Nurse Anesthetist, Certified Registered | 1000 Medical Center Boulevard, Lawrenceville, GA 30046 | 2018-11-27 |
| 1679060388 | Christopher Puckett | Student in an Organized Health Care Education/Training Program | 665 Duluth Hwy Suite 501, Lawrenceville, GA 30046 | 2018-04-18 |
| 1457851255 | Advanced Urology Institute of Georgia | Urology | 501 Crown Point Way, Lawrenceville, GA 30046 | 2018-02-19 |
| 1013447044 | Pharmacy Investments of Lawrenceville, LLC | Pharmacy | 738 Old Norcross Road, Ste A, Lawrenceville, GA 30046 | 2017-06-13 |
| 1225577000 | Priority Housecalls LLC | Clinic/Center | 225 Scenic Hwy, Ste 200, Lawrenceville, GA 30046 | 2017-02-14 |
| Find all providers in zip 30046 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902420573 | Brenda Willis-wade | Internal Medicine | 1600 Keswick Place Dr, Lawrenceville, GA 30043-6627 | 2020-05-30 |
| 1780123588 | Feliks Shtindler Md PC | Internal Medicine | 3450 Princeton Pike, Suite 120, Lawrenceville, NJ 08648 | 2017-02-14 |
| 1902200835 | Odianosen I Obadan | Internal Medicine | 601 Professional Dr Ste 235a, Lawrenceville, GA 30046-7697 | 2014-10-21 |
| 1831416270 | Nidhip Anil Patel | Internal Medicine | 500 Medical Center Blvd Ste 310, Lawrenceville, GA 30046-3332 | 2010-04-26 |
| 1700108784 | North Atlanta Medical Clinic, L.l.c | Internal Medicine | 3664 Club Drive, Suite 201, Lawrenceville, GA 30044 | 2010-02-18 |
| 1932355294 | New Horizons Internal Medicine LLC | Internal Medicine | 771 Old Norcross Rd Ste 110, Lawrenceville, GA 30045-4317 | 2008-08-18 |
| 1376704106 | Samuel Deutsch Md PC | Internal Medicine | 316 W Pike St Ste 100, Lawrenceville, GA 30045-4878 | 2008-06-24 |
| 1033385877 | Neel Jitendra Gandhi | Internal Medicine | 2997 Princeton Pike, #201, Lawrenceville, NJ 08648 | 2008-05-01 |
| 1184899510 | Edward Joseph Ostrowski | Internal Medicine | 276 Fieldboro Dr, Lawrenceville, NJ 08648-3914 | 2008-04-27 |
| 1376717504 | Victorine Mafoueka Nguena | Internal Medicine | 3664 Club Dr Ste 201, Lawrenceville, GA 30044-2959 | 2008-04-18 |
| Find all providers in LAWRENCEVILLE | ||||
| City | LAWRENCEVILLE |
| Zip Code | 30046 |
Please comment or provide details below to improve the information on REVIVE MEDICAL CENTER, LLC.
| 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.