DR. BRUNDA REVANNA M.D. NPI 1689646135

Family Medicine in Jacksonville, AL

NPI 1689646135 Individual Female Years of Experience 19 Family Medicine PECOS Enrolled Accepts Medicare Approved Payment

About BRUNDA REVANNA

Brunda Revanna is a primary care provider established in Jacksonville, Alabama and her medical specialization is family medicine with more than 19 years of experience. She graduated from Mercer University School Of Medicine in 2003. The NPI number of Brunda Revanna is 1689646135 and was assigned on February 2006. The practitioner's primary taxonomy code is 207Q00000X with license number 00025426 (AL). The provider is registered as an individual and her NPI record was last updated 6 years ago.

A primary care provider (PCP) like Dr. Brunda Revanna M.d. sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Brunda Revanna is enrolled in PECOS and is eligible to order or refer healthcare services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices

Brunda Revanna is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

NPI

1689646135

Provider NameDR. BRUNDA REVANNA M.D.
Provider Location Address1465A 1ST AVE SW STE A JACKSONVILLE, AL 36265
Provider Mailing Address950 EAGLES LANDING PWKY #321 STOCKBRIDGE, GA 30281
GenderFemale
NPI Entity TypeIndividual
Medical School NameMERCER UNIVERSITY SCHOOL OF MEDICINE
Graduation Year2003
Is Sole Proprietor?Yes
Is Organization Subpart?N/A
Enumeration Date02-07-2006
Last Update Date06-15-2015


Primary Taxonomy

Taxonomy Code207Q00000X
ClassificationFamily Medicine
TypeAllopathic & Osteopathic Physicians
License No.00025426
License StateAL
Taxonomy DescriptionFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Business Address

DR. BRUNDA REVANNA M.D.
1465A 1ST AVE SW STE A
JACKSONVILLE, AL
ZIP 36265
Phone: (256) 435-8383

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Mailing Address

DR. BRUNDA REVANNA M.D.
950 EAGLES LANDING PWKY #321
STOCKBRIDGE, GA
ZIP 30281
Phone: (678) 432-4755
Fax: (678) 432-4753



Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
009930945MEDICAID (05)AL
051517109MEDICARE ID-TYPE UNSPECIFIED (04)AL
051517109OTHER (01)
270060909OTHER (01)
H3509MEDICARE UPIN (02)AL

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.