REVIDA RECOVERY CENTERS PC NPI 1013483486

NPI Information

  • NPI: 1013483486
  • Provider Name: REVIDA RECOVERY CENTERS, PC
  • Classification: Family Medicine - 207QA0401X
  • Specialization: Addiction Medicine
  • Entity Type: Organization
  • CLIA Number: 44D2268468
  • Address: 300 VALLEY ST NE
    ABINGDON, VA
    ZIP 24210
  • Phone: (276) 206-8197

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NPI Details

REVIDA RECOVERY CENTERS, PC is an addiction medicine family medicine in Abingdon, VA. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. REVIDA RECOVERY CENTERS, PC NPI is 1013483486. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

300 VALLEY ST NE
ABINGDON, VA
ZIP 24210-912
Phone: (276) 206-8197

The provider's authorized official is Matthew Thomas .
The authorized official title is Ceo and has the following contact phone number (423) 631-0432.

The CLIA number assigned to this NPI record is 44D2268468 - other - obot with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/23/2018 and was last updated on 9/8/2025.

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
1207QA0401XFamily MedicineAddiction MedicineYes

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
11013483486MEDICAIDVIRGINIA
2Q045064MEDICAIDTENNESSEE

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: 11/21/2025

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