REVIVAL PAIN MANAGEMENT INC (NPI# 1801813712) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801813712 |
| 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 | 3368355330 |
| Practice Fax Number | 3368355337 |
| Mailing Telephone | 7329285346 |
| Mailing Fax Number | 7329287434 |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2011-07-26 |
| Authorized Official Name | EMIDIO NOVEMBRE (PRESIDENT) |
| Authorized Official Telephone | 3368355330 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
200201393 | NC | Allopathic & Osteopathic Physicians |
| 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 |
| 1164729257 | Revival Pain Management, Inc | Pain Medicine | 110 Dutchman Ct, Elkin, NC 28621-2237 | 2011-02-25 |
| 1265514194 | Ben Alfred Raines | Family Medicine | 110 Dutchman Ct, Elkin, NC 28621 | 2006-10-19 |
| 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 | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| 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 Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750308664 | Emidio Michael Novembre | Anesthesiology | 110 Dutchman's Court, Elkin, NC 28621-2457 | 2006-07-16 |
| 1851848329 | Anesthesia Services Associates | Anesthesiology | 505 Samaritans Ridge Ct, Elkin, NC 28621-2457 | 2016-09-01 |
| 1225379910 | Surry Regional Health Services Inc. | Anesthesiology | 110 Dutchman Ct, Elkin, NC 28621-2237 | 2013-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174164057 | Regenerative Medical Institute,pllc | Anesthesiology | 1305 W. Wendover Ave., Ste A, Greensboro, NC 27408 | 2019-10-02 |
| 1598235830 | Mission Community Anesthesiology Specialists LLC | Anesthesiology | 89 Hospital Dr Ste C, Brevard, NC 28712-4838 | 2018-11-29 |
| 1508341736 | Bethany Medical Center | Anesthesiology | 190 Independence Ave Ste B, North Wilkesboro, NC 28659-4270 | 2018-10-03 |
| 1508347048 | Premier Pain Solutions Pllc | Anesthesiology | 5710 Oleander Dr Ste 201, Wilmington, NC 28403-4722 | 2018-08-23 |
| 1417434069 | Kyle Mason Fisher | Anesthesiology | Duke Univeristy Hospital Anesthesia Department, Durham, NC 27710-0001 | 2018-07-26 |
| 1306351432 | Carteret Surgical Associates P.a. | Anesthesiology | 2145 Country Club Rd Ste 400, Jacksonville, NC 28546-2400 | 2017-12-12 |
| 1003331521 | Accela Spine and Pain, Pllc | Anesthesiology | 10120 Ivey Chase Lane, Apt 617, Charlotte, NC 28277 | 2017-08-04 |
| 1205372588 | Interventional Pain Center, Pllc | Anesthesiology | 517 B Hwy 210 N, Spring Lake, NC 28390 | 2017-01-11 |
| 1316482201 | Providence Pain, Spine & Recovery, Pllc | Anesthesiology | 7 Berkshire Rd, Smithfield, NC 27577 | 2016-12-30 |
| 1356898720 | Ketamine Wellness Institute | Anesthesiology | 414 Cosgrove Ave, Chapel Hill, NC 27514-5271 | 2016-09-02 |
| 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.