REVIVE ORTHOPEDICS SPINE & SPORTS MEDICINE, INC
NPI 1306563663
Clinic/Center - Multi-Specialty in Lithia Springs, GA
About Revive Orthopedics Spine & Sports Medicine, Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
REVIVE ORTHOPEDICS SPINE & SPORTS MEDICINE, INC (NPI 1306563663), doing business as Revive Orthopedics Spine & Sports Medicine, is a healthcare organization registered as a multi-specialty in Lithia Springs, Georgia and active in the NPI registry since October 2022. The organization lists Shevin D Pollydore, Physician/owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 5
Other Names 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Revive Orthopedics Spine & Sports Medicine, Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
6Medicare enrollment records show 6 clinicians reassign Medicare billing to Revive Orthopedics Spine & Sports Medicine, Inc, which bills Medicare for the services they deliver. Of these, 4 practice at this address. They are listed nearest first.
Clinicians, nearest first (6)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 1306563663. It was assigned to this organization in the NPPES registry on October 26, 2022. 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 939 Bob Arnold Blvd Ste A, Lithia Springs, GA 30122. The listed phone number is (770) 209-9913.
What is Revive Orthopedics Spine & Sports Medicine, Inc's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.
Is Revive Orthopedics Spine & Sports Medicine, Inc enrolled in Medicare?
Yes. Revive Orthopedics Spine & Sports Medicine, Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Revive Orthopedics Spine & Sports Medicine, Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 3 Medicare specialties reassign their Medicare billing to Revive Orthopedics Spine & Sports Medicine, Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Orthopedic Surgery (4), Nurse Practitioner (1) and Physical Medicine and Rehabilitation (1). Of these, 4 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Revive Orthopedics Spine & Sports Medicine, Inc was last updated on October 26, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Revive Orthopedics Spine & Sports Medicine, Inc · NPI 1306563663
Multi-Specialty organization in Lithia Springs, Georgia. Organization record, active in the CMS NPPES registry since October 26, 2022.
## Identity
- **NPI:** 1306563663 (Entity type: Organization)
- **Enumerated:** October 26, 2022
- **Primary specialty:** Clinic/Center - Multi-Specialty · taxonomy 261QM1300X
- **Also known as:** Revive Orthopedics Spine & Sports Medicine (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Shevin Pollydore, PHYSICIAN/OWNER
## Practice location
- **Address:** 939 BOB ARNOLD BLVD STE A, Lithia Springs, GA 30122-3258
- **Phone:** (770) 209-9913 · **Fax:** (678) 902-8579
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 6 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Orthopedic Surgery (4), Nurse Practitioner (1), Physical Medicine and Rehabilitation (1); 4 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 26, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1306563663) · Data from the CMS NPPES public registry.