NPIMap

Individual provider Active NPI

Emidio Michael Novembre, DO

  • Interventional Pain Medicine Physician
  • Elkin, NC
National Provider Identifier
1750308664
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
200201393 Issued in NC
Practice address
110 Dutchman CT
Elkin, NC 28621-2237
Phone
(336) 835-5330
Fax
(336) 835-5337
NPI assigned
Jul 16, 2006
Last updated
Nov 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Anesthesiology) Physician 207LA0401X 2002-01393 NC
Pain Medicine (Anesthesiology) Physician 207LP2900X 200201393 NC
Interventional Pain Medicine Physician 208VP0014X 200201393 NC Primary

Addresses

Primary practice location

110 Dutchman CT
Elkin, NC 28621-2237

Mailing address

1925 N Bridge St Ste 101
Elkin, NC 28621-2105
Phone (336) 835-5330

Other practice location 1

1909 W Park Dr
North Wilkesboro, NC 28659-3564
Phone (336) 835-5330

Other practice location 2

905 Rockford St Lowr Level
Mount Airy, NC 27030-5323
Phone (336) 835-5330

Other identifiers 2

IdentifierTypeStateIssuer
010126401MedicaidVA
89132UVMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040123000983 NC Practitioner - Interventional Pain ManagementPractitioner - AnesthesiologyPractitioner - Addiction Medicine 5294637336 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain ManagementAlso: Addiction Medicine
Education
Midwestern University, Chicago College of Osteopathic Med, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Revival Pain Management IncGroup PAC ID 6406922343, 3 clinicians

Practice addresses (Care Compare)

1925 N Bridge St
Suite 101
Elkin, NC 28621-2105
Phone (336) 835-5330

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2002-01393NCMDAddiction Medicine (Anesthesiology) Physician
200201393NCMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Hospital of Surry County Current Accepting new patients
Triumph Anesthesia & Pain Interventional Pain Medicine PastSince Oct 29, 2002 Accepting new patients
Ocean Perioperative Consultants P.a. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: enovembre@rpm.gwaydirect.com

Organizations & group practices 4

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.

Hospital & facility affiliations 7

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": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1750308664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 N BRIDGE ST STE 101",
            "city": "ELKIN",
            "state": "NC",
            "postal_code": "286212105",
            "telephone_number": "336-835-5330",
            "fax_number": "336-835-5337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 DUTCHMAN CT",
            "city": "ELKIN",
            "state": "NC",
            "postal_code": "286212237",
            "telephone_number": "336-835-5330",
            "fax_number": "336-835-5337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1909 W Park Dr",
            "address_purpose": "LOCATION",
            "city": "North Wilkesboro",
            "state": "NC",
            "postal_code": "286593564",
            "country_code": "US",
            "telephone_number": "336-835-5330",
            "fax_number": "336-835-5337",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "905 Rockford St Lowr Level",
            "address_purpose": "LOCATION",
            "city": "Mount Airy",
            "state": "NC",
            "postal_code": "270305323",
            "country_code": "US",
            "telephone_number": "336-835-5330",
            "fax_number": "336-835-5337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOVEMBRE",
        "first_name": "EMIDIO",
        "middle_name": "MICHAEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LA0401X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Addiction Medicine",
            "state": "NC",
            "license": "2002-01393",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NC",
            "license": "200201393",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NC",
            "license": "200201393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010126401",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89132UV",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkin, NC

Sources for this page

Verify at the official NPI Registry.