NPIMap

Organization Active NPI

Revida Recovery Centers, PC

  • Addiction Medicine (Family Medicine) Physician
  • Abingdon, VA
National Provider Identifier
1013483486
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
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
Last updated
Sep 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Matthew Thomas, DONPI 1801862313
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)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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 Directory

Locations

4140 Thornton Taylor Pkwy
Fayetteville, TN 37334
Phone (931) 434-8109

712 Professional Plaza Dr
Greeneville, TN 37745
Phone (423) 820-0432

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

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, and the practitioner matching its NPPES authorized official.

View all 43

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": [],
    "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.

Verify at the official NPI Registry.