Active NPI
Blake Revlett
- Physician Assistant
- Murfreesboro, TN
National Provider Identifier
1346955168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA0000005269
- Practice address
- 1508 Carl Adams Dr Unit 200
Murfreesboro, TN 37129-4375 - Phone
- (615) 893-4896
- NPI assigned
- Jan 16, 2023
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA0000005269 | TN | Primary |
Addresses
Primary practice location
1508 Carl Adams Dr Unit 200
Murfreesboro, TN 37129-4375
Mailing address
2220 Spain Hill Rd
Lascassas, TN 37085-5143
Phone (615) 785-9563
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1508 Carl Adams Dr
Suite 200
Murfreesboro, TN 37129-4375
Phone 6158934896178
3326 Aspen Grove Dr
Suite 260
Franklin, TN 37067-2866
Phone 6158934896178
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.16 of 100
- Quality
- 91.08
- Promoting interoperability
- 98
- Improvement activities
- 40
- Cost
- 77.78
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA0000005269 | TN | MD | Physician Assistant |
Organizations & group practices 1
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.
-
- Sleep Medicine (Internal Medicine) Physician
- Murfreesboro, TN
- NPI 1003914201
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673827200000",
"number": "1346955168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2220 SPAIN HILL RD",
"city": "LASCASSAS",
"state": "TN",
"postal_code": "370855143",
"telephone_number": "615-785-9563"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1508 CARL ADAMS DR UNIT 200",
"city": "MURFREESBORO",
"state": "TN",
"postal_code": "371294375",
"telephone_number": "615-893-4896"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REVLETT",
"first_name": "BLAKE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-01-16",
"last_updated": "2023-01-16",
"certification_date": "2023-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TN",
"license": "PA0000005269",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Murfreesboro, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; 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.
- 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.