NPIMap

Organization Active NPI

Surry Regional Health Services Inc.

Doing business as Revival Pain Management

  • Pain Medicine (Anesthesiology) Physician
  • Elkin, NC
National Provider Identifier
1225379910
Registry record updated Nov 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
SURRY REGIONAL HEALTH SERVICES INC.
Doing business as
Revival Pain Management
Practice address
110 Dutchman CT
Elkin, NC 28621-2237
Phone
(336) 835-5330
Fax
(336) 835-5337
NPI assigned
Mar 6, 2013
Last updated
Nov 12, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2014

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

Authorized official

Name
Mr. Gregory Schulz
Title
VP Surry Regional Health Services
Phone
(336) 783-8353

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X NC Primary

Addresses

Primary practice location

110 Dutchman CT
Elkin, NC 28621-2237

Mailing address

PO Box 1267
Mount Airy, NC 27030-1267
Phone (336) 786-4522

Other names 1

  • Revival Pain Management Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1362528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415750400000",
    "number": "1225379910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1267",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270301267",
            "telephone_number": "336-786-4522",
            "fax_number": "336-786-3752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 DUTCHMAN CT",
            "city": "ELKIN",
            "state": "NC",
            "postal_code": "286212237",
            "telephone_number": "336-835-5330",
            "fax_number": "336-835-5337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURRY REGIONAL HEALTH SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-06",
        "last_updated": "2014-11-12",
        "status": "A",
        "authorized_official_last_name": "SCHULZ",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "VP SURRY REGIONAL HEALTH SERVICES",
        "authorized_official_telephone_number": "336-783-8353",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revival Pain Management",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elkin, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.