Revelstone Family Practice

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

REVELSTONE FAMILY PRACTICE

Practice address

232 Concord Rd
Albemarle, NC 28001-4612

Phone

(704) 986-3900

Fax

(704) 986-3913

NPI assigned

Feb 9, 2016

Last updated

Mar 17, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Edward Allen Kepp, MDNPI 1194785899

Title

Owner

Phone

(704) 986-3900

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Edward A Kepp, MD

  • Internal Medicine Physician
  • Albemarle, NC
  • NPI 1194785899

  Family Medicine

  Medicare reassignment NPD Authorized official
• Emily Rose Greenlee, FNP-C

  • Family Nurse Practitioner
  • Albemarle, NC
  • NPI 1639575376
  Medicare reassignment NPD
• Brenda J Harkey, FNP

  • Family Nurse Practitioner
  • Albemarle, NC
  • NPI 1316967086
  NPD
• Jeffery Chance

  • Physician Assistant
  • Albemarle, NC
  • NPI 1437147105
  NPD (past)
• Phyllis T. Kupsick, FNP-C

  • Family Nurse Practitioner
  • Albemarle, NC
  • NPI 1033199682
  NPD (past)
• Debra D Powell, PA-C

  • Physician Assistant
  • Denver, NC
  • NPI 1184677395
  NPD (past)
• Connie Sue Wallace, PA-C

  • Physician Assistant
  • Huntersville, NC
  • NPI 1619179132
  NPD (past)
• Scott A Young, PA-C

  • Medical Physician Assistant
  • Charleston, SC
  • NPI 1699705103
  NPD (past)

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

{
    "created_epoch": "1454976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615939200000",
    "number": "1790143436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 CONCORD RD",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280014612",
            "telephone_number": "704-986-3900",
            "fax_number": "704-986-3913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 CONCORD RD",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280014612",
            "telephone_number": "704-986-3900",
            "fax_number": "704-986-3913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVELSTONE FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-09",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A",
        "authorized_official_last_name": "KEPP",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-986-3900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9400873",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8947986",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danford E Raynor II, OD
• Stephen Reber, PA-C
• Ravi Kanth Reddy, MD
• Sara Elizabeth Redwine, PTA
• Cynthia Patrick Reinhardt, LPC
• Revive Therapy LLC (Covenant Case Management Services)
• Robert J Reynolds, MD
• Rha Behavioral Health NC LLC
• Rha Health Services Inc
• Rha Health Services NC LLC

• Family Medicine Physician in Albemarle, NC
• Providers in Albemarle, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.