Revived Medical Community Clinic

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

REVIVED MEDICAL COMMUNITY CLINIC

Practice address

2724 W Palmetto St Ste 5
Florence, SC 29501-4909

Phone

(843) 799-2649

NPI assigned

Dec 11, 2024

Organization subpart

No

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

Authorized official

Name

Lavanda Martin, APRNNPI 1548936404

Title

Ceo,Owner

Phone

(843) 799-2649

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lavanda Ayana Smoot Martin, FNP-BC

  • Family Nurse Practitioner
  • Florence, SC
  • NPI 1548936404
  NPD Authorized official

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

{
    "created_epoch": "1733875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736121600000",
    "number": "1306653688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2724 W PALMETTO ST STE 5",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295014909",
            "telephone_number": "843-799-2649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2724 W PALMETTO ST STE 5",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295014909",
            "telephone_number": "843-799-2649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVED MEDICAL COMMUNITY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-11",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "LAVANDA",
        "authorized_official_title_or_position": "CEO,OWNER",
        "authorized_official_telephone_number": "843-799-2649",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reliance Medical Supplies LLC
• Remed LLC
• Resilientshe Women'S Care, LLC
• Respiratory Products, Inc
• Caitlin Revell
• Revived Medical Lab, LLC
• Carolyn Reynolds, MD
• Carolyn Estelle Reynolds, COTA/L
• Mark A Reynolds, MD
• George A Rhame Jr., RPH

• Clinic/Center in Florence, SC
• Providers in Florence, SC by specialty
• Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; 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.