Active NPI
Revida Recovery Centers, PC
- Addiction Medicine (Family Medicine) Physician
- Abingdon, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction Medicine (Family Medicine) Physician
- Legal business name
- REVIDA RECOVERY CENTERS, PC
- Practice address
- 300 Valley St NE
Abingdon, VA 24210-2912 - Phone
- (276) 206-8197
- NPI assigned
- Oct 23, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Matthew Thomas, DO
- Title
- Ceo
- Phone
- (423) 631-0432
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Family Medicine) Physician | 207QA0401X | Primary |
Addresses
Primary practice location
300 Valley St NE
Abingdon, VA 24210-2912
Mailing address
3322 W End Ave Ste 350
Nashville, TN 37203-6911
Other practice location 1
4140 Thornton Taylor Pkwy
Fayetteville, TN 37334-2289
Phone (931) 434-8109
Other practice location 2
161 Mose Dr
Sparta, TN 38583-1502
Phone (931) 222-0139
Other practice location 3
106 Administration Rd Ste 3
Oak Ridge, TN 37830-6954
Phone (865) 276-6212
Other practice location 4
5864 Highway 153 Ste 112
Hixson, TN 37343-5187
Phone (423) 243-3342
Other practice location 5
2911 Essary Dr Ste 200
Knoxville, TN 37918-2469
Phone (865) 371-8101
Other practice location 6
712 Professional Plaza Dr
Greeneville, TN 37745-5138
Phone (423) 820-0432
Other practice location 7
3114 Browns Mill Rd
Johnson City, TN 37604-1417
Phone (423) 631-0432
Other practice location 8
2001 Highland Ave
Knoxville, TN 37916-1217
Phone (865) 633-0353
Other practice location 9
127 Ledford Mill Rd
Tullahoma, TN 37388-2278
Phone (931) 841-3311
Other practice location 10
255 Holston Rd
Wytheville, VA 24382-4448
Phone (276) 227-0206
Other practice location 11
230 Bowman St Ste C
Morristown, TN 37813-3871
Phone (423) 586-3249
Other practice location 12
198 Ross Carter Blvd
Duffield, VA 24244-5117
Phone (276) 690-7161
Other practice location 13
330 Heritage Blvd
Newport, TN 37821-4241
Phone (423) 623-7043
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013483486 | Medicaid | VA | |
| Q045064 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN, VA
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190724003393 | TN | Part B Supplier - Clinic/Group Practice | 1153657473 |
Receives reassigned benefits from 37 practitioners Practice locations: Tullahoma, TN; Sparta, TN; Hixson, TN; Oak Ridge, TN; Newport, TN; Morristown, TN; Knoxville, TN; Johnson City, TN… |
| O20190904001928 | VA | Part B Supplier - Clinic/Group Practice | 1153657473 |
Receives reassigned benefits from 13 practitioners Practice locations: Wytheville, VA; Abingdon, VA; Duffield, VA |
National Provider Directory
National Provider DirectoryLocations
4140 Thornton Taylor Pkwy
Ste D
Fayetteville, TN 37334
Phone (931) 434-8109
4140 Thornton Taylor Pkwy
Fayetteville, TN 37334
Phone (931) 434-8109
5870 Highway 153
Ste 122
Hixson, TN 37343
Phone (423) 243-3342
230 Bowman St
Ste C
Morristown, TN 37813
Phone (423) 586-3249
3322 West End Ave
Ste 350
Nashville, TN 37203
400 Overbeck Ln
Ste 201
Nashville, TN 37204
106 Administration Rd
Ste 3
Oak Ridge, TN 37830
Phone (865) 276-6212
127 Ledford Mill Rd
Tullahoma, TN 37388
Phone (931) 841-3311
Networks
- devoted network organization-8e25d2a3-4243-4ca7-9a42-cceb4e4f5c4b
Practitioners & affiliated clinicians
Practitioners 43
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Physician
- Abingdon, VA
- NPI 1295179364
Addiction Medicine, TN, VA
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540252800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757289600000",
"number": "1013483486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3322 W END AVE STE 350",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372036911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 VALLEY ST NE",
"city": "ABINGDON",
"state": "VA",
"postal_code": "242102912",
"telephone_number": "276-206-8197"
}
],
"practiceLocations": [
{
"address_1": "4140 Thornton Taylor Pkwy",
"address_purpose": "LOCATION",
"city": "Fayetteville",
"state": "TN",
"postal_code": "373342289",
"country_code": "US",
"telephone_number": "931-434-8109",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "161 Mose Dr",
"address_purpose": "LOCATION",
"city": "Sparta",
"state": "TN",
"postal_code": "385831502",
"country_code": "US",
"telephone_number": "931-222-0139",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "106 Administration Rd Ste 3",
"address_purpose": "LOCATION",
"city": "Oak Ridge",
"state": "TN",
"postal_code": "378306954",
"country_code": "US",
"telephone_number": "865-276-6212",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5864 Highway 153 Ste 112",
"address_purpose": "LOCATION",
"city": "Hixson",
"state": "TN",
"postal_code": "373435187",
"country_code": "US",
"telephone_number": "423-243-3342",
"fax_number": "423-402-8155",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2911 Essary Dr Ste 200",
"address_purpose": "LOCATION",
"city": "Knoxville",
"state": "TN",
"postal_code": "379182469",
"country_code": "US",
"telephone_number": "865-371-8101",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "712 Professional Plaza Dr",
"address_purpose": "LOCATION",
"city": "Greeneville",
"state": "TN",
"postal_code": "377455138",
"country_code": "US",
"telephone_number": "423-820-0432",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3114 Browns Mill Rd",
"address_purpose": "LOCATION",
"city": "Johnson City",
"state": "TN",
"postal_code": "376041417",
"country_code": "US",
"telephone_number": "423-631-0432",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2001 Highland Ave",
"address_purpose": "LOCATION",
"city": "Knoxville",
"state": "TN",
"postal_code": "379161217",
"country_code": "US",
"telephone_number": "865-633-0353",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "127 Ledford Mill Rd",
"address_purpose": "LOCATION",
"city": "Tullahoma",
"state": "TN",
"postal_code": "373882278",
"country_code": "US",
"telephone_number": "931-841-3311",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "255 Holston Rd",
"address_purpose": "LOCATION",
"city": "Wytheville",
"state": "VA",
"postal_code": "243824448",
"country_code": "US",
"telephone_number": "276-227-0206",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "230 Bowman St Ste C",
"address_purpose": "LOCATION",
"city": "Morristown",
"state": "TN",
"postal_code": "378133871",
"country_code": "US",
"telephone_number": "423-586-3249",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "198 Ross Carter Blvd",
"address_purpose": "LOCATION",
"city": "Duffield",
"state": "VA",
"postal_code": "242445117",
"country_code": "US",
"telephone_number": "276-690-7161",
"fax_number": "276-690-7246",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "330 Heritage Blvd",
"address_purpose": "LOCATION",
"city": "Newport",
"state": "TN",
"postal_code": "378214241",
"country_code": "US",
"telephone_number": "423-623-7043",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "REVIDA RECOVERY CENTERS, PC",
"organizational_subpart": "NO",
"enumeration_date": "2018-10-23",
"last_updated": "2025-09-08",
"certification_date": "2025-09-08",
"status": "A",
"authorized_official_last_name": "THOMAS",
"authorized_official_first_name": "MATTHEW",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "423-631-0432",
"authorized_official_credential": "DO"
},
"taxonomies": [
{
"code": "207QA0401X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine, Addiction Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1013483486",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q045064",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Abingdon, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.