Revive Pain & Spine Center Inc

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

20A13486 Issued in CA

Legal business name

REVIVE PAIN & SPINE CENTER INC

Practice address

3609 Mission Ave Ste D
Carmichael, CA 95608-2955

Phone

(530) 650-8333

Fax

(530) 650-8388

NPI assigned

Aug 14, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Akbar Khan, DONPI 1528383833

Title

President of Corporation

Phone

(530) 650-8333

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Akbar Khan, D.O.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Carmichael, CA
  • NPI 1528383833
  Medicare reassignment NPD Authorized official
• Damandeep Kaur Badwal, MD

  • Addiction Medicine (Preventive Medicine) Physician
  • Rancho Cordova, CA
  • NPI 1760838981
  Medicare reassignment NPD
• Erica Corrin Feder, NP

  • Nurse Practitioner
  • Sacramento, CA
  • NPI 1144489998
  Medicare reassignment NPD
• Erika Minerva Gonzalez-Uribe, NP

  • Family Nurse Practitioner
  • Woodland, CA
  • NPI 1467103689
  Medicare reassignment NPD
• Andrew J Linn, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Sacramento, CA
  • NPI 1093908832
  Medicare reassignment NPD
• Salaiman Rasoli, PA-C

  • Physician Assistant
  • Carmichael, CA
  • NPI 1245976943
  Medicare reassignment
• Seung Kwon Lee, M.D.

  • Surgery Physician
  • Elk Grove, CA
  • NPI 1700880267
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1534204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730073600000",
    "number": "1063991685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W COURT ST STE D",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "956952986",
            "telephone_number": "530-650-8333",
            "fax_number": "530-650-8388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3609 MISSION AVE STE D",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956082955",
            "telephone_number": "530-650-8333",
            "fax_number": "530-650-8388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "255 W Court St Ste D",
            "address_purpose": "LOCATION",
            "city": "Woodland",
            "state": "CA",
            "postal_code": "956952986",
            "country_code": "US",
            "telephone_number": "530-650-8333",
            "fax_number": "530-650-8388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REVIVE PAIN & SPINE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-14",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "AKBAR",
        "authorized_official_title_or_position": "PRESIDENT OF CORPORATION",
        "authorized_official_telephone_number": "530-650-8333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CA",
            "license": "20A13486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1407843162",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1528383833",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linnea Ivlen Renwick, PA-C
• Res-Care California, Inc.
• Rescare California, Inc.
• James Robes Respicio, COTA/L
• Rev Vascular Inc
• Revive Pain & Spine Center, Inc.
• Marissa Jordan Reyes
• Hanz Caeasar Reynado
• Kevin David Rhyner
• Lloyd Lowell Rich, M.D.

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Carmichael, CA
• Providers in Carmichael, CA by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; 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.