William Robert Revelette, MD

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

31337 Issued in KY

Practice address

101 Orchard Dr
Nicholasville, KY 40356-2690

Phone

(859) 881-4288

Fax

(859) 881-4388

NPI assigned

Mar 7, 2006

Last updated

Jun 24, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Healthpoint Family Care Inc

  • Federally Qualified Health Center (FQHC)
  • Newport, KY
  • NPI 1508889742
  Medicare reassignment NPD
• Healthpoint Family Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Wilmore, KY
  • NPI 1689419608
  NPD
• Linda a Lear M D P C

  dba Hometown Pediatrics

  • Pediatrics Physician
  • Nicholasville, KY
  • NPI 1780736132
  NPD (past)

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1639146996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E 11TH ST",
            "city": "NEWPORT",
            "state": "KY",
            "postal_code": "410712203",
            "telephone_number": "859-655-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 ORCHARD DR",
            "city": "NICHOLASVILLE",
            "state": "KY",
            "postal_code": "403562690",
            "telephone_number": "859-881-4288",
            "fax_number": "859-881-4388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVELETTE",
        "first_name": "WILLIAM",
        "middle_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "31337",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "KY",
            "license": "31337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64313372",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Renewed Performance, LLC
• Restart Clinic, PLLC
• Restoration Christian Counseling
• Revel Dental,PSC
• Pamela Ann Revel, DMD
• Revive Ministries Inc
• Revive Ministries Inc
• Revive Ministries Inc
• Revive Ministries Inc
• Revive Ministries Inc (Revive Life House Outpatient Center)

• Pediatric Adolescent Medicine Physician in Nicholasville, KY
• Providers in Nicholasville, KY by specialty
• Pediatric Adolescent Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; 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.