NPIMap

Individual provider Active NPI

Reva Gill, MD

  • Internal Medicine Physician
  • Riverdale, MD
National Provider Identifier
1184782369
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0050951 Issued in MD
Practice address
6510 Kenilworth Avenue
Suite 2400
Riverdale, MD 20737
Phone
(301) 927-2711
Fax
(301) 277-4834
NPI assigned
Dec 4, 2006
Last updated
Nov 26, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0050951 MD Primary

Addresses

Primary practice location

6510 Kenilworth Avenue
Suite 2400
Riverdale, MD 20737

Mailing address

6510 Kenilworth Avenue
Suite 2400
Riverdale, MD 20737
Phone (301) 927-2711

Other practice location 1

51 Hospital Rd
Newnan, GA 30263-1209
Phone (770) 251-5544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100617000014 DC Practitioner - Internal Medicine 0749310811 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6510 Kenilworth Ave
Riverdale, MD 20737-1347

6510 Kenilworth Ave
Suite 2400
Riverdale, MD 20737-1346
Phone (301) 927-2711

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0050951MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Joint Regeneration & Anti-Aging of Current Accepting new patients
Kenilworth Internists, P.a Internal Medicine CurrentSince Jan 4, 1997 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

6510 Kenilworth Ave
Ste 2400
Riverdale, MD 20737
Phone (301) 927-2711

Organizations & group practices 4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1184782369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6510 KENILWORTH AVENUE",
            "address_2": "SUITE 2400",
            "city": "RIVERDALE",
            "state": "MD",
            "postal_code": "20737",
            "telephone_number": "301-927-2711",
            "fax_number": "301-277-4834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6510 KENILWORTH AVENUE",
            "address_2": "SUITE 2400",
            "city": "RIVERDALE",
            "state": "MD",
            "postal_code": "20737",
            "telephone_number": "301-927-2711",
            "fax_number": "301-277-4834"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "51 Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Newnan",
            "state": "GA",
            "postal_code": "302631209",
            "country_code": "US",
            "telephone_number": "770-251-5544",
            "fax_number": "855-552-3776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILL",
        "first_name": "REVA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0050951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverdale, MD

Sources for this page

Verify at the official NPI Registry.