GREGORY BLAKE REVETTE (NPI# 1114533023) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114533023 |
| Entity Type | Individual |
| Full Name | GREGORY BLAKE REVETTE |
| Credential | MS, ATC |
| Practice Address |
910 Warrior Dr Centre AL 35960-1099 |
| Mailing Address |
400 County Road 574 Centre AL 35960-6658 |
| Practice Telephone | 6014798614 |
| Mailing Telephone | 6014798614 |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2020-09-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
1093 | AL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
910 WARRIOR DR |
| City | CENTRE |
| State | AL |
| Zip Code | 35960-1099 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306364955 | Sharonda Coutch | Nurse Practitioner | 1925 W Main St Ste 102, Centre, AL 35960 | 2017-09-05 |
| 1972925451 | Valerie Sanchez Leonard | Nurse Practitioner | 1260 Chesnut Bypass, Suite A, Centre, AL 35960 | 2014-01-17 |
| 1417021403 | Deans Drugs Inc. | Pharmacy | 699 Cedar Bluff Rd, Centre, AL 35960 | 2006-11-20 |
| 1710067160 | Larry Mitchell | Emergency Medicine | 1550 County Road 487, Centre, AL 35960 | 2006-10-17 |
| 1922116615 | J & A Pharmacy Inc Centre | Pharmacy | 1490 Chesnut Bypass, Centre, AL 35960 | 2006-08-25 |
| 1811554660 | Allied Cardiovascular Services | Internal Medicine | 1260 Chesnut Bypass, Suite B, Centre, AL 35960 | 2019-05-28 |
| 1144712738 | Floyd Cherokee Medical Center LLC | Emergency Medicine | 400 Northwood Dr, Centre, AL 35960 | 2018-05-31 |
| 1932627585 | Kristina Hagan | Nurse Practitioner | 1925 W Main St Ste 102, Centre, AL 35960 | 2017-09-05 |
| 1518170398 | Jeff Graves | Pharmacist | 1490 Chesnut Bypass, Centre, AL 35960 | 2007-05-08 |
| 1396764395 | Fort Payne Clinic Corp. | Orthopaedic Surgery | 200 Medical Center Drive, Attn: Director of Physician Practices, Fort Payne, AL 35960 | 2006-07-19 |
| Find all providers in zip 35960 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063010270 | Jane Ferguson | Specialist/Technologist | 3831 3rd Ave, Apt 31, Tuscaloosa, AL 35405 | 2020-10-12 |
| 1114524261 | David B Bentley | Specialist/Technologist | 1121 Williamsburg Dr, Mobile, AL 36695-3541 | 2020-10-01 |
| 1710590567 | Jessica Snider | Specialist/Technologist | 300 Cedars Rd, Munford, AL 36268-7105 | 2020-08-30 |
| 1427660158 | Faith Anneliese Monroe | Specialist/Technologist | 229 Dozier Dr Apt 415, Troy, AL 36081-3040 | 2020-08-24 |
| 1063024792 | Timothy Sullivan | Specialist/Technologist | 601 E Elm St Apt 1203, Troy, AL 36081-3498 | 2020-08-24 |
| 1972115616 | Hannah Grace Foster | Specialist/Technologist | 4031 Wiregrass Dr, Dothan, AL 36301-9500 | 2020-08-22 |
| 1609493089 | James David Bush | Specialist/Technologist | 1147 Highway 231 S Ste 9&10, Troy, AL 36081-3026 | 2020-07-01 |
| 1245850338 | Krishanna Le'mya Johnson | Specialist/Technologist | 4590 Mccalla Trace Pkwy, Bessemer, AL 35022-5490 | 2020-04-20 |
| 1619505906 | Lauren Julich | Specialist/Technologist | 2012 Crossvine Rd, Hoover, AL 35244-1512 | 2020-03-31 |
| 1508494220 | Miranda E Slack | Specialist/Technologist | 525 Frank Thomas Ave Apt 5, Tuscaloosa, AL 35401-2265 | 2020-03-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.