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REVIVE ORTHOPEDICS SPINE & SPORTS MEDICINE
NPI 1023705837
Orthopaedic Surgery in Roswell, GA

Active since April 20, 2023CLIA Certified · 5 labs
45 W CROSSVILLE RD STE 503, ROSWELL, GA 30075(770) 769-1724(770) 708-6599 Get Directions Write a Review

NPPES record last updated: April 20, 2023. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Revive Orthopedics Spine & Sports Medicine NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

REVIVE ORTHOPEDICS SPINE & SPORTS MEDICINE (NPI 1023705837) is a healthcare organization registered as an orthopaedic surgery in Roswell, Georgia and active in the NPI registry since April 2023. The organization holds 5 active CLIA laboratory certificates and lists Shevin D. Pollydore, Owner, as its authorized official.

NPPES Registry Identity

NPI1023705837
Entity TypeOrganization
Primary Taxonomy207X00000X
Legal Business NameREVIVE ORTHOPEDICS SPINE & SPORTS MEDICINE, INC
Location Address45 W CROSSVILLE RD STE 503Roswell, GA 30075-2964
Mailing Address939 Bob Arnold Blvd Ste ALithia Springs, GA 30122-3258 · (770) 769-1724 · Fax (770) 708-6599
Phone(770) 769-1724
Fax(770) 708-6599
Organization SubpartNo
Authorized OfficialShevin D. PollydoreOwner · (770) 769-1724
Enumeration DateApril 20, 2023
NPPES CertifiedApril 20, 2023
✔ NPI 1023705837 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
Also ListedPhysical Medicine & RehabilitationTaxonomy 208100000X
Also ListedPhysical Medicine & Rehabilitation · Pain MedicineTaxonomy 2081P2900X
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacyTaxonomy 333600000X
45 W CROSSVILLE RD STE 503, Roswell, GA 30075
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Other Names 1

Doing Business AsRevive Orthopedics Spine & Sports Medicine

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 5

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2339554

Revive Orthopedics Spine & Sports Medicine · Stockbridge, GA
Active · expires Mar 3, 2028
CLIA Number11D2339554
Laboratory TypePhysician Office
Certificate Effective DateMarch 4, 2026
Certificate Expiration DateMarch 3, 2028
Laboratory DirectorShevin Pollydore
Laboratory Phone(770) 769-1724
Laboratory LocationRevive Orthopedics Spine & Sports Medicine216 Willis Drive, Stockbridge, GA 30281
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 11D2339555

Revive Orthopedics Spine & Sports Medicine · Peachtree City, GA
Active · expires Mar 3, 2028
CLIA Number11D2339555
Laboratory TypePhysician Office
Certificate Effective DateMarch 4, 2026
Certificate Expiration DateMarch 3, 2028
Laboratory DirectorShevin Pollydore
Laboratory Phone(770) 769-1724
Laboratory LocationRevive Orthopedics Spine & Sports Medicine3200 Shakerag Hill, Suite A, Peachtree City, GA 30269
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 11D2339557

Revive Orthopedics Spine & Sports Medicine · Loganville, GA
Active · expires Mar 3, 2028
CLIA Number11D2339557
Laboratory TypePhysician Office
Certificate Effective DateMarch 4, 2026
Certificate Expiration DateMarch 3, 2028
Laboratory DirectorShevin Pollydore
Laboratory Phone(770) 769-1724
Laboratory LocationRevive Orthopedics Spine & Sports Medicine3955 Harrison Road, Suite 200 B, Loganville, GA 30052
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 11D2327354

Revive Orthopedics Spine & Sports Medicine · Lithia Springs, GA
Active · expires Jul 21, 2027
CLIA Number11D2327354
Laboratory TypePhysician Office
Certificate Effective DateJuly 22, 2025
Certificate Expiration DateJuly 21, 2027
Laboratory DirectorIndira Hidalgo
Laboratory Phone(770) 769-1724
Laboratory LocationRevive Orthopedics Spine & Sports Medicine939 Bob Arnold Road Blvd, Suite A, Lithia Springs, GA 30122
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 11D2339537

Rivive Orthopedics Spine & Sports Medicine · Dunwoody, GA
Active · expires Mar 3, 2028
CLIA Number11D2339537
Laboratory TypePhysician Office
Certificate Effective DateMarch 4, 2026
Certificate Expiration DateMarch 3, 2028
Laboratory DirectorShevin Pollydore
Laboratory Phone(770) 769-1724
Laboratory LocationRivive Orthopedics Spine & Sports Medicine1750 Old Spring House Lane, Suite 205, Dunwoody, GA 30338
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Revive Orthopedics Spine & Sports Medicine, Inc's NPI number?

The NPI number for Revive Orthopedics Spine & Sports Medicine, Inc is 1023705837. It was assigned to this organization in the NPPES registry on April 20, 2023. The provider is doing business as Revive Orthopedics Spine & Sports Medicine.

Where is Revive Orthopedics Spine & Sports Medicine, Inc located?

Revive Orthopedics Spine & Sports Medicine, Inc is located at 45 W Crossville Rd Ste 503, Roswell, GA 30075. The listed phone number is (770) 769-1724.

What is Revive Orthopedics Spine & Sports Medicine, Inc's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Does Revive Orthopedics Spine & Sports Medicine, Inc hold CLIA laboratory certificates?

Yes. 5 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Revive Orthopedics Spine & Sports Medicine, Inc was last updated on April 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.