DR. BONNIE CAUKINS REVELLE MD NPI 1225087349

NPI Information

NPI: 1225087349
Provider Name: DR. BONNIE CAUKINS REVELLE, MD
Classification: Pediatrics - 2080N0001X
Entity Type: Individual

Specialization: Neonatal-Perinatal Medicine

Address:
601 CHILDRENS LN
NORFOLK, VA
ZIP 23507
Phone: (757) 668-7456
Get Directions

DR. Bonnie Caukins Revelle, MD is a neonatal-perinatal medicine pediatrics in Norfolk, VA. The provider is a pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. DR. Bonnie Caukins Revelle, MD NPI is 1225087349. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

601 CHILDRENS LN
NORFOLK, VA
ZIP 23507-910
Phone: (757) 668-7456
Fax: (757) 668-9255

The enumeration date for this NPI number is 5/8/2006 and was last updated on 5/14/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208000000X	Pediatrics		27288	NORTH CAROLINA	No
2	208000000X	Pediatrics		0101240729	VIRGINIA	No
3	2080N0001X	Pediatrics	Neonatal-Perinatal Medicine	0101240729	VIRGINIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	561929096	OTHER	NORTH CAROLINA	FEDERAL TAX ID NUMBER
2	8971295	MEDICAID	NORTH CAROLINA
3	71295	OTHER	NORTH CAROLINA	BLUE CROSS BLUE SHIELD
4	890160M	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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