Active NPI
Nathan Revels
- Pharmacist
- Tifton, GA
National Provider Identifier
1598646846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH035837
- Practice address
- 620 Virginia Ave N
Tifton, GA 31794-4227 - Phone
- (229) 386-1166
- NPI assigned
- Sep 11, 2025
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH035837 | GA | Primary |
Addresses
Primary practice location
620 Virginia Ave N
Tifton, GA 31794-4227
Mailing address
620 Virginia Ave N
Tifton, GA 31794-4227
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH035837 | GA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1757548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757808000000",
"number": "1598646846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 VIRGINIA AVE N",
"city": "TIFTON",
"state": "GA",
"postal_code": "317944227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 VIRGINIA AVE N",
"city": "TIFTON",
"state": "GA",
"postal_code": "317944227",
"telephone_number": "229-386-1166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REVELS",
"first_name": "NATHAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-09-11",
"last_updated": "2025-09-14",
"certification_date": "2025-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH035837",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tifton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.