Individual provider Active NPI

Ross Revella, DC

  • Chiropractor
  • St Petersburg, FL
National Provider Identifier
1548818917
Registry record updated Jan 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
12906 Issued in FL
Practice address
5415 4TH St N
St Petersburg, FL 33703-2249
Phone
(727) 521-4244
NPI assigned
Aug 29, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 12906 FL Primary

Addresses

Primary practice location

5415 4TH St N
St Petersburg, FL 33703-2249

Mailing address

5415 4TH St N
St Petersburg, FL 33703-2249
Phone (727) 521-4244

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200123000677 FL Practitioner - Chiropractic 0143655035 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bayside Sport and Spine PLLCGroup PAC ID 7719490531, 2 clinicians

Practice addresses (Care Compare)

5415 4TH St N
St Petersburg, FL 33703-2249
Phone (727) 521-4244

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12906FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Bayside Sport & Spine PLLC Chiropractor CurrentSince May 18, 2025 Accepting new patients
Hollstrom & Associates Inc Chiropractor CurrentSince Nov 21, 2019 Accepting new patients
Brian D Brill DC PLLC Chiropractor Current Accepting new patients
Advanced Medical of Florida LLC PastSince Dec 14, 2020 Accepting new patients
Umbra Inc Past Accepting new patients

Locations

11444 Seminole Blvd
Largo, FL 33778
Phone (727) 201-4105

5415 4th St N
St Petersburg, FL 33703
Phone (727) 521-4244

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24544/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1567036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769299200000",
    "number": "1548818917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5415 4TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337032249",
            "telephone_number": "727-521-4244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5415 4TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337032249",
            "telephone_number": "727-521-4244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVELLA",
        "first_name": "ROSS",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-29",
        "last_updated": "2026-01-25",
        "certification_date": "2026-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "12906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2026; 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.