WILLIAM ROBERT REVELETTE MD
NPI 1639146996
Pediatrics - Adolescent Medicine in Nicholasville, KY

Q: What is William Revelette's NPI number?

The NPI number for William Revelette is 1639146996. It was assigned to this individual provider in the NPPES registry on March 7, 2006.

Q: What is William Revelette's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

Q: When was this NPI record last updated?

The NPPES record for William Revelette was last updated on June 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since March 07, 2006PECOS Enrolled

101 ORCHARD DR, NICHOLASVILLE, KY 40356(859) 881-4288(859) 881-4388 Get Directions Write a Review

NPPES record last updated: June 24, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 24, 2024, Apr 3, 2021, Mar 15, 2021 and 1 more (4 updates tracked since 2019).

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About William Robert Revelette Md NPPES

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

WILLIAM ROBERT REVELETTE MD (NPI 1639146996) is an individual adolescent medicine provider in Nicholasville, Kentucky, licensed in Kentucky (31337) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1639146996

Entity TypeIndividualMale

Primary Taxonomy2080A0000X

Provider Legal NameWILLIAM ROBERT REVELETTECredential: MD

Location Address101 ORCHARD DRNicholasville, KY 40356-2690

Mailing Address215 E 11th StNewport, KY 41071-2203 · (859) 655-6100

Phone(859) 881-4288

Fax(859) 881-4388

Sole ProprietorNo

Enumeration DateMarch 7, 2006

Last NPPES UpdateJune 24, 20244 updates tracked since enumeration

NPPES CertifiedJune 24, 2024

✔ NPI 1639146996 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080A0000X

License✔ Licensed in KY · 31337

Definition

A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.

Also ListedPediatricsTaxonomy 208000000X · License 31337 (KY)

101 ORCHARD DR, Nicholasville, KY 40356

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Other Identifiers 1

Medicaid64313372KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

William Robert Revelette Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHAEL DALE SARTEN JR. PMHNP-BC

Nurse Practitioner (Psychiatric/Mental Health)