Active NPI
James Clifford Revis, CRNA
- Certified Registered Nurse Anesthetist
- Fort Hood, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- RN282004
- Practice address
- 36065 Santa Fe Ave
Fort Hood, TX 76544 - Phone
- (254) 288-8000
- NPI assigned
- Jul 3, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | RN282004 | GA | Primary |
Addresses
Primary practice location
36065 Santa Fe Ave
Fort Hood, TX 76544
Mailing address
416 San Gabriel River Rd
Georgetown, TX 78626-2178
Phone (513) 504-2700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4777 E Galbraith Rd
Cincinnati, OH 45236-2725
Phone (513) 686-3000
Hospital & facility affiliations
- The Jewish Hospital-Mercy Health
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN282004 | GA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anesthesia & Intensive Care Consultants,Inc. | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Southwest Ohio Anesthesia Consultants LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
13500 Powers Ct
Ste 230
Fort Myers, FL 33912
Phone (239) 610-0784
3000 Hospital Dr
Batavia, OH 45103
Phone (513) 557-3209
4777 E Galbraith Rd
Cincinnati, OH 45236
Phone (513) 686-3000
7500 State Rd
Cincinnati, OH 45255
Phone (513) 624-4034
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.
-
- Anesthesiology Physician
- Cincinnati, OH
- NPI 1588645188
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Batavia, OH
- NPI 1164859013
Nurse Anesthetist, Certified Registered
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Cincinnati, OH
- NPI 1336478163
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593734400000",
"number": "1831716026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "416 SAN GABRIEL RIVER RD",
"city": "GEORGETOWN",
"state": "TX",
"postal_code": "786262178",
"telephone_number": "513-504-2700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36065 SANTA FE AVE",
"city": "FORT HOOD",
"state": "TX",
"postal_code": "76544",
"telephone_number": "254-288-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REVIS",
"first_name": "JAMES",
"middle_name": "CLIFFORD",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-07-03",
"last_updated": "2020-07-03",
"certification_date": "2020-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "GA",
"license": "RN282004",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Hood, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.