Reveal Genomics USA Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

REVEAL GENOMICS USA INC.

Practice address

150 N Research Campus Dr.
Office 4320, Suite 4314
Kannapolis, NC 28081

Phone

(704) 250-2690

Fax

(212) 947-6246

NPI assigned

Apr 23, 2024

Last updated

Apr 23, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Wesley Hunter Buckingham, BSC

Title

Vice President, Market Access

Phone

(773) 569-0628

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1713830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713830400000",
    "number": "1114772902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 N RESEARCH CAMPUS DR.",
            "address_2": "OFFICE 4320, SUITE 4314",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "28081",
            "telephone_number": "704-250-2690",
            "fax_number": "212-947-6246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 N RESEARCH CAMPUS DR.",
            "address_2": "OFFICE 4320, SUITE 4314",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "28081",
            "telephone_number": "704-250-2690",
            "fax_number": "212-947-6246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVEAL GENOMICS USA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-23",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A",
        "authorized_official_last_name": "BUCKINGHAM",
        "authorized_official_first_name": "WESLEY",
        "authorized_official_middle_name": "HUNTER",
        "authorized_official_title_or_position": "VICE PRESIDENT, MARKET ACCESS",
        "authorized_official_telephone_number": "773-569-0628",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BSC"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Kannapolis, NC by specialty
• Clinical Medical Laboratory in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.