REVIVE ORTHOPEDICS SPINE & SPORTS SURGERY CENTER INC – NPI #1972283141
Clinic/Center

REVIVE ORTHOPEDICS SPINE & SPORTS SURGERY CENTER INC is an AHC clinic located in LITHIA SPRINGS, GA. NPPES has assigned the NPI number 1972283141 to REVIVE ORTHOPEDICS SPINE & SPORTS SURGERY CENTER INC on July 21, 2023. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for REVIVE ORTHOPEDICS SPINE & SPORTS SURGERY CENTER INC below.

NPI Profile for
REVIVE ORTHOPEDICS SPINE & SPORTS SURGERY CENTER INC

NPI Number
1972283141
Enumeration Date

(about 3 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
REVIVE ORTHOPEDICS SPINE & SPORTS SURGERY CENTER INC
Primary location
939 BOB ARNOLD BLVD STE D
LITHIA SPRINGS, GA 30122-3258
Phone: (770) 769-1724 Fax: (770) 708-6599
Mailing address
939 BOB ARNOLD BLVD STE A
LITHIA SPRINGS, GA 30122-3258
Phone: (770) 769-1724 Fax:
Organization Subpart
No
Authorized Official
SHEVIN POLLYDORE
CEO
Phone: (770) 769-1724
Updated
Certification Date
Jul 21, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.