WILLIAM ROBERT REVELETTE MD NPI 1639146996

NPI Information

  • NPI: 1639146996
  • Provider Name: WILLIAM ROBERT REVELETTE, MD
  • Classification: Pediatrics - 2080A0000X
  • Specialization: Adolescent Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 101 ORCHARD DR
    NICHOLASVILLE, KY
    ZIP 40356
  • Phone: (859) 881-4288

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NPI Details

William Robert Revelette, MD is an adolescent medicine pediatrics in Nicholasville, KY. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. William Robert Revelette, MD NPI is 1639146996. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

101 ORCHARD DR
NICHOLASVILLE, KY
ZIP 40356-690
Phone: (859) 881-4288
Fax: (859) 881-4388

The NPI 1639146996 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/7/2006 and was last updated on 6/24/2024.

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
1208000000XPediatrics31337KENTUCKYNo
22080A0000XPediatricsAdolescent Medicine31337KENTUCKYYes

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
164313372MEDICAIDKENTUCKY

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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