Active NPI
Taylor Ashley Revere
- Emergency Medicine Physician
- Atlanta, GA
National Provider Identifier
1255072450
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 113721
- Practice address
- 550 Peachtree St NE
Atlanta, GA 30308-2212 - Phone
- (404) 686-4411
- NPI assigned
- Apr 5, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Emergency Medicine Physician | 207P00000X | 113721 | GA | Primary |
Addresses
Primary practice location
550 Peachtree St NE
Atlanta, GA 30308-2212
Mailing address
One Gustave Levy Place, Box 1149
New York, NY 10029
Phone (770) 344-7167
Other practice location 1
1 Gustave L Levy Pl
New York, NY 10029-6504
Phone (770) 344-7167
Other practice location 2
1364 Clifton Rd NE
Atlanta, GA 30322-1059
Phone (404) 712-7100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781136000000",
"number": "1255072450",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "ONE GUSTAVE LEVY PLACE, BOX 1149",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10029",
"telephone_number": "770-344-7167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 PEACHTREE ST NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303082212",
"telephone_number": "404-686-4411"
}
],
"practiceLocations": [
{
"address_1": "1 Gustave L Levy Pl",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100296504",
"country_code": "US",
"telephone_number": "770-344-7167",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1364 Clifton Rd NE",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303221059",
"country_code": "US",
"telephone_number": "404-712-7100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "REVERE",
"first_name": "TAYLOR",
"middle_name": "ASHLEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-05",
"last_updated": "2026-06-11",
"certification_date": "2026-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "GA",
"license": "113721",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.