Korey Lee Revels, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4292 Issued in NC

Practice address

5511 Raeford Rd
Suite 100
Fayetteville, NC 28304-2057

Phone

(910) 487-1300

Fax

(910) 487-0030

NPI assigned

Jul 10, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

American Chiropractic CareGroup PAC ID 5597726406, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• American Chiropractic Care

  • Chiropractor
  • Fayetteville, NC
  • NPI 1194821520
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1341878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358812800000",
    "number": "1336404953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5511 RAEFORD RD",
            "address_2": "SUITE 100",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283042057",
            "telephone_number": "910-487-1300",
            "fax_number": "910-487-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5511 RAEFORD RD",
            "address_2": "SUITE 100",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283042057",
            "telephone_number": "910-487-1300",
            "fax_number": "910-487-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVELS",
        "first_name": "KOREY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-10",
        "last_updated": "2013-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "4292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Restorative Nursing Services
• Restorative Therapeutic Counseling
• Mallory Claire Rettenmeier, PT, DPT
• Matthew Ryan Rettig, PHARMD
• Okisha Denna Reuben
• Kyla Revels
• Revolution Incorporated
• Revolution Incorporated
• Revolution USA Group Incorporated
• Jaime Reyes Gonzalez, MA

• Chiropractor in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Chiropractor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2013; 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.

Verify at the official NPI Registry.