Individual provider Active NPI

Virginia Revill

  • Family Medicine Physician
  • Newport, TN
National Provider Identifier
1144859802
Registry record updated Nov 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
27359 Issued in TN
Practice address
1586 Depaul Rd
Newport, TN 37821-6280
Phone
(678) 793-5448
NPI assigned
Apr 5, 2020
Last updated
Nov 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 27359 TN Primary

Addresses

Primary practice location

1586 Depaul Rd
Newport, TN 37821-6280

Mailing address

1586 Depaul Rd
Newport, TN 37821-6280
Phone (678) 793-5448

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240417000780 TN Practitioner - Nurse Practitioner 9335588839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care of the Smokies LLC.Group PAC ID 4183905292, 5 clinicians

Practice addresses (Care Compare)

1015 E Pkwy
Gatlinburg, TN 37738-5057
Phone (865) 412-1225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27359TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care of the Smokies LLC CurrentSince Apr 9, 2024 Accepting new patients

Locations

1015 E Parkway
Gatlinburg, TN 37738
Phone (865) 412-1225

2656 Parkway
Ste 4
Pigeon Forge, TN 37863
Phone (865) 366-3264

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1586044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1144859802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1586 DEPAUL RD",
            "city": "NEWPORT",
            "state": "TN",
            "postal_code": "378216280",
            "telephone_number": "678-793-5448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1586 DEPAUL RD",
            "city": "NEWPORT",
            "state": "TN",
            "postal_code": "378216280",
            "telephone_number": "678-793-5448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVILL",
        "first_name": "VIRGINIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-05",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "27359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, TN

Sources for this page

Verify at the official NPI Registry.