REVELSTONE FAMILY PRACTICE NPI 1790143436

NPI Information

  • NPI: 1790143436
  • Provider Name: REVELSTONE FAMILY PRACTICE
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • CLIA Number: 34D0963359
  • Address: 232 CONCORD RD
    ALBEMARLE, NC
    ZIP 28001
  • Phone: (704) 986-3900

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NPI Details

REVELSTONE FAMILY PRACTICE is a family medicine in Albemarle, NC. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. REVELSTONE FAMILY PRACTICE NPI is 1790143436. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

232 CONCORD RD
ALBEMARLE, NC
ZIP 28001-612
Phone: (704) 986-3900
Fax: (704) 986-3913

The provider's authorized official is Edward Allen Kepp .
The authorized official title is Owner and has the following contact phone number (704) 986-3900.

The CLIA number assigned to this NPI record is 34D0963359 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/9/2016 and was last updated on 3/17/2021.

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
1207Q00000XFamily Medicine9400873NORTH CAROLINANo
2363LF0000XNurse PractitionerFamilyNo
3363LW0102XNurse PractitionerWomen's HealthNo
4207Q00000XFamily 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
18947986MEDICAIDNORTH 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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