Londa Lynne Revis, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

2212-C Issued in AR

Practice address

495 Hogan LN Ste 2
Conway, AR 72034-8498

Phone

(501) 358-6695

Fax

(501) 358-6860

NPI assigned

Mar 11, 2008

Last updated

Sep 30, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Tilley Family Medicine PAGroup PAC ID 8224012505, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Tilley Family Medicine, PA

  • Family Medicine Physician
  • Conway, AR
  • NPI 1679581730
  Medicare reassignment Care Compare group NPD
• Conway Regional Medical Center Inc

  dba Conway Regional Mobile Health Unit

  • Family Medicine Physician
  • Conway, AR
  • NPI 1043183544
  NPD
• Conway Regional Medical Center, Inc

  dba Conway Regional Counseling Center

  • Psychiatry Physician
  • Conway, AR
  • NPI 1730402249
  NPD

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1912177486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9662",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720339662",
            "telephone_number": "501-358-6695",
            "fax_number": "501-358-6860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 HOGAN LN STE 2",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720348498",
            "telephone_number": "501-358-6695",
            "fax_number": "501-358-6860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVIS",
        "first_name": "LONDA",
        "middle_name": "LYNNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-11",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AR",
            "license": "2212-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hunter Rennie, DO
• Jamie Reprogle
• Doris Resimont, BA, CIT
• Restoration Health of Conway
• Resurrected Hope Therapy, LLC
• Maylin Reyes Solis
• Cecilia Mai Reyes, PA
• Allison Reynolds, LPC
• Anita Lea Reynolds
• Brandi Reynolds, RECOVERY ASSISTANT

• Social Worker in Conway, AR
• Providers in Conway, AR by specialty
• Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.