Active NPI
Revay O Corbett, ATC, PHD
- Sports Medicine (Physical Medicine & Rehabilitation) Physician
- Brentwood, NY
National Provider Identifier
1952926743
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Physical Medicine & Rehabilitation) Physician
- License
- 002418
- Practice address
- 185 Noble St
Brentwood, NY 11717-6512 - Phone
- (929) 352-3824
- NPI assigned
- Jun 8, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Sports Medicine (Physical Medicine & Rehabilitation) Physician | 2081S0010X | 002418 | NY | Primary |
Addresses
Primary practice location
185 Noble St
Brentwood, NY 11717-6512
Mailing address
185 Noble St
Brentwood, NY 11717-6512
Phone (929) 352-3824
Other names 1
- Dr. Revay O Corbett
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | https://forms.gle/2ZQznR7vkZN7whni6 | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002418 | NY | MD | Art Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592092800000",
"number": "1952926743",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "185 NOBLE ST",
"city": "BRENTWOOD",
"state": "NY",
"postal_code": "117176512",
"telephone_number": "929-352-3824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "185 NOBLE ST",
"city": "BRENTWOOD",
"state": "NY",
"postal_code": "117176512",
"telephone_number": "929-352-3824"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORBETT",
"first_name": "REVAY",
"middle_name": "O",
"name_prefix": "Prof.",
"credential": "ATC, PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-08",
"last_updated": "2020-06-14",
"certification_date": "2020-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "2081S0010X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation, Sports Medicine",
"state": "NY",
"license": "002418",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "https://forms.gle/2ZQznR7vkZN7whni6",
"affiliation": "N",
"endpointDescription": "Contact Us Survey",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "Contact Request",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Google Form",
"address_1": "185 Noble St",
"city": "Brentwood",
"state": "NY",
"country_code": "US",
"postal_code": "117176512",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "REVAY",
"last_name": "CORBETT",
"middle_name": "O",
"prefix": "DR.",
"credential": "ATC, PHD",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Brentwood, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.