Active NPI
Lynnette Renee Reville, M.A., CCC-A
- Audiologist
- Melbourne, FL
National Provider Identifier
1316110216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- AY000498
- Practice address
- 1325 South Apollo
Melbourne, FL 32901 - Phone
- (321) 508-6455
- NPI assigned
- Apr 11, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | AY000498 | FL | Primary |
Addresses
Primary practice location
1325 South Apollo
Melbourne, FL 32901
Mailing address
1325 S.Apollo
Dr Blenda Dickenson
Melbourne, FL 32901
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Audiologist
- Education
- Other, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1755 N Mecklenburg Ave
South Hill, VA 23970-4080
Phone (434) 447-3151
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.74 of 100
- Quality
- 74.5
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 77.96
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AY000498 | FL | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CMH Physician Services, LLC | Current | Accepting new patients | |
| MCV Associated Physicians | Current | Accepting new patients | |
| CMH Physician Services, LLC | Current | Accepting new patients | |
| Hearusa Inc | Past | Accepting new patients |
Locations
401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409
1755 N Mecklenburg Ave
South Hill, VA 23970
Phone (434) 584-2273
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 and National Provider Directory roles.
-
- Anesthesiology Physician
- Richmond, VA
- NPI 1710959457
-
- Internal Medicine Physician
- South Hill, VA
- NPI 1194760645
-
- Hospitalist Physician
- South Hill, VA
- NPI 1386028793
-
- Audiologist-Hearing Aid Fitter
- West Palm Beach, FL
- NPI 1073560231
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391472000000",
"number": "1316110216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1325 S.APOLLO",
"address_2": "DR BLENDA DICKENSON",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "32901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1325 SOUTH APOLLO",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "32901",
"telephone_number": "321-508-6455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REVILLE",
"first_name": "LYNNETTE",
"middle_name": "RENEE",
"credential": "M.A., CCC-A",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-11",
"last_updated": "2014-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "FL",
"license": "AY000498",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.