Active NPI
Revella Health Inc
- General Practice Physician
- Birmingham, AL
National Provider Identifier
1639996192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- Legal business name
- REVELLA HEALTH INC
- Practice address
- 1 Perimeter Park S Ste 100N
Birmingham, AL 35243-3248 - Phone
- (205) 929-7451
- NPI assigned
- Sep 25, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Daniel Yeboah
- Title
- Ceo
- Phone
- (205) 929-7451
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | |||
| Family Medicine Physician | 207Q00000X | |||
| Internal Medicine Physician | 207R00000X | |||
| General Practice Physician | 208D00000X | Primary | ||
| Nursing Care Agency | 251J00000X | |||
| In Home Supportive Care Agency | 253Z00000X | |||
| Health Service Clinic/Center | 261QH0100X | |||
| Infusion Therapy Clinic/Center | 261QI0500X | |||
| Multi-Specialty Clinic/Center | 261QM1300X | |||
| Medical Specialty Clinic/Center | 261QM2500X | |||
| Primary Care Clinic/Center | 261QP2300X | |||
| Rehabilitation Clinic/Center | 261QR0400X | |||
| Recovery Care Clinic/Center | 261QR0800X | |||
| Point of Service | 305S00000X | |||
| Pharmacy | 333600000X |
Addresses
Primary practice location
1 Perimeter Park S Ste 100N
Birmingham, AL 35243-3248
Mailing address
1 Perimeter Park S Ste 100N
Birmingham, AL 35243-3248
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 01D2334377 | Revella Health | Certificate of waiver | Nov 18, 2027 |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727222400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1728864000000",
"number": "1639996192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 PERIMETER PARK S STE 100N",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352433248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 PERIMETER PARK S STE 100N",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352433248",
"telephone_number": "205-929-7451"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "REVELLA HEALTH INC",
"organizational_subpart": "NO",
"enumeration_date": "2024-09-25",
"last_updated": "2024-10-14",
"certification_date": "2024-10-14",
"status": "A",
"authorized_official_last_name": "YEBOAH",
"authorized_official_first_name": "DANIEL",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "205-929-7451"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": null,
"license": null,
"primary": true
},
{
"code": "251J00000X",
"taxonomy_group": "",
"desc": "Nursing Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QH0100X",
"taxonomy_group": "",
"desc": "Clinic/Center, Health Service",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QI0500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Infusion Therapy",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QM1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Multi-Specialty",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QM2500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Medical Specialty",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QR0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rehabilitation",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QR0800X",
"taxonomy_group": "",
"desc": "Clinic/Center, Recovery Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "305S00000X",
"taxonomy_group": "",
"desc": "Point of Service",
"state": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.