Individual provider Active NPI

Grantland Sutton Reviere, DO

  • Orthopaedic Surgery Physician
  • Phenix City, AL
National Provider Identifier
1639064181
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
17863 Issued in GA
Practice address
4401 Riverchase Dr
Phenix City, AL 36867-7483
Phone
(334) 732-3000
NPI assigned
Jun 12, 2025
Last updated
Jun 12, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 17863 GA Primary

Addresses

Primary practice location

4401 Riverchase Dr
Phenix City, AL 36867-7483

Mailing address

7036 Spring Walk Dr
Columbus, GA 31904-2717
Phone (731) 217-4433

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
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
17863GAMDOrthopaedic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1749686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1639064181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7036 SPRING WALK DR",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319042717",
            "telephone_number": "731-217-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 RIVERCHASE DR",
            "city": "PHENIX CITY",
            "state": "AL",
            "postal_code": "368677483",
            "telephone_number": "334-732-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVIERE",
        "first_name": "GRANTLAND",
        "middle_name": "SUTTON",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-12",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "17863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phenix City, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.

Verify at the official NPI Registry.