DR. BONNIE CAUKINS REVELLE MD NPI 1225087349

NPI Information

  • NPI: 1225087349
  • Provider Name: DR. BONNIE CAUKINS REVELLE, MD
  • Classification: Pediatrics - 2080N0001X
  • Specialization: Neonatal-Perinatal Medicine
  • Entity Type: Individual
  • Address: 601 CHILDRENS LN
    NORFOLK, VA
    ZIP 23507
  • Phone: (757) 668-7456

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NPI Details

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
1208000000XPediatrics27288NORTH CAROLINANo
2208000000XPediatrics0101240729VIRGINIANo
32080N0001XPediatricsNeonatal-Perinatal Medicine0101240729VIRGINIAYes

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
1561929096OTHERNORTH CAROLINAFEDERAL TAX ID NUMBER
28971295MEDICAIDNORTH CAROLINA
371295OTHERNORTH CAROLINABLUE CROSS BLUE SHIELD
4890160MMEDICAIDNORTH 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: 3/30/2025

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