REVIVE SPINE AND PAIN CENTER
NPI 1457896003
Physical Medicine & Rehabilitation - Sports Medicine in Marlton, NJ
NPI Status: Active since January 05, 2017
Contact Information
1001 LINCOLN DR W STE E
MARLTON, NJ
ZIP 08053
Phone: (856) 983-9001
Fax: (856) 983-9011
- Organization
- Physical Medicine & Rehabilitation
- Sports Medicine
- CLIA Number: 31D2133848
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 05-31-2026
About REVIVE SPINE AND PAIN CENTER
This page provides the complete NPI Profile along with additional information for Revive Spine And Pain Center, a provider established in Marlton, New Jersey operating as a Physical Medicine & Rehabilitation, focusing in sports medicine . The healthcare provider is registered in the NPI registry with number 1457896003 assigned on January 2017. The practitioner's primary taxonomy code is 2081S0010X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The authorized official of this NPI record is Dr. Michael Rizkalla Md (Director)
- NPI
- 1457896003
- Provider Name
- REVIVE SPINE AND PAIN CENTER
- Entity Type
- Organization
- Location Address
- 1001 LINCOLN DR W STE E MARLTON, NJ 08053
- Location Phone
- (856) 983-9001
- Location Fax
- (856) 983-9011
- Mailing Address
- PO BOX 1126 ABSECON, NJ 08201
- Mailing Phone
- (856) 983-9001
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-05-2017
- Last Update Date
- 01-31-2024
- Code Navigator
Location Map
Secondary Locations
- 555 Route 18 Ste 201
East Brunswick, NJ 08816
(732) 955-9139 - 1245 Whitehorse Mercerville Rd Ste 407
Hamilton, NJ 08619
(609) 581-2400
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physical Medicine & Rehabilitation Sports Medicine
- Taxonomy Code
- 2081S0010X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 261QP3300X | Ambulatory Health Care Facilities | Clinic/Center | 25MA08922900 (NJ) |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 31D2133848
- Facility Type
- Physician Office
- Certificate Effective Date
- February 23, 2024
- Certificate Expiration Date
- May 31, 2026
- Laboratory Director
- SAMIP R. BHATTARAI
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Revive Spine And Pain Center after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1457896003, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 57 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
MARLTON, NJ 08053
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1457896003, enumerated as an "organization" on January 05, 2017.
The provider is located at 1001 LINCOLN DR W STE E MARLTON, NJ 08053 and the phone number is (856) 983-9001.
Physical Medicine & Rehabilitation with taxonomy code 2081S0010X and a focus in Sports Medicine.
