Chrystine Rae Revelli, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

857570 Issued in NV

Practice address

7675 Mission Valley Rd
San Diego, CA 92108-4429

Phone

(800) 316-6314

NPI assigned

Jul 26, 2022

Sex

Female

Sole proprietor

Yes

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 NV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: crevelli713004@direct.med.utah.edu

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

{
    "created_epoch": "1658793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1629704267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7675 MISSION VALLEY RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084429",
            "telephone_number": "800-316-6314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7675 MISSION VALLEY RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084429",
            "telephone_number": "800-316-6314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVELLI",
        "first_name": "CHRYSTINE",
        "middle_name": "RAE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-26",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "857570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marsha Sonia Kadze Reuther, M.D.
• Lexie L Revekant, PT, DPT
• Carlos Reveles, LVN
• Shanae Revell
• Thomas Revell
• Janet Mary Revels, PMHNP
• Revival DME Corp
• Revivamed Medical Corporation
• Revive Medical of San Diego
• Revive Medspa

• Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.