Individual provider Active NPI

Holly Lynne Revling, FNP-BC

  • Family Nurse Practitioner
  • Buckhannon, WV
National Provider Identifier
1700779964
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
123948 Issued in WV
Practice address
94 W Main St
Buckhannon, WV 26201-2284
Phone
(304) 473-2202
Fax
(304) 473-2211
NPI assigned
May 29, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 123948 WV Primary

Addresses

Primary practice location

94 W Main St
Buckhannon, WV 26201-2284

Mailing address

94 W Main St
Buckhannon, WV 26201-2284
Phone (304) 473-2202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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

Enrollment IDStateProvider typePAC IDDetails
I20251219001480 WV Practitioner - Nurse Practitioner 6507351277 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

94 W Main St
Buckhannon, WV 26201-2284
Phone (304) 473-2199

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
123948WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Hospital of Buckhannon Inc CurrentSince Oct 1, 2025 Accepting new patients
St Josephs Hospital of Buckhannon Past Accepting new patients

Locations

1 Amalia Dr
Buckhannon, WV 26201
Phone (304) 473-2000

21 Auction Ln
Buckhannon, WV 26201
Phone (304) 472-0245

94 W Main St
Buckhannon, WV 26201
Phone (304) 473-2200

Organizations & group practices 2

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1748476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1700779964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 W MAIN ST",
            "city": "BUCKHANNON",
            "state": "WV",
            "postal_code": "262012284",
            "telephone_number": "304-473-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 W MAIN ST",
            "city": "BUCKHANNON",
            "state": "WV",
            "postal_code": "262012284",
            "telephone_number": "304-473-2202",
            "fax_number": "304-473-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVLING",
        "first_name": "HOLLY",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-29",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "123948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buckhannon, WV

Sources for this page

Verify at the official NPI Registry.