REVIVAL PAIN MANAGEMENT INC
NPI 1801813712
Pain Medicine - Interventional Pain Medicine in Elkin, NC

Q: What is Revival Pain Management Inc's NPI number?

The NPI number for Revival Pain Management Inc is 1801813712. It was assigned to this organization in the NPPES registry on July 16, 2006.

Q: What is Revival Pain Management Inc's specialty?

The primary specialty registered for this NPI is Pain Medicine, specializing in Interventional Pain Medicine, with taxonomy code 208VP0014X.

Active since July 16, 2006

1925 N BRIDGE ST STE 101, ELKIN, NC 28621(336) 835-5330(336) 835-5337 Get Directions Write a Review

NPPES record last updated: November 20, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 20, 2025, Jul 10, 2023, Aug 12, 2022 and 1 more (4 updates tracked since 2021).

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About Revival Pain Management Inc NPPES

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

REVIVAL PAIN MANAGEMENT INC (NPI 1801813712) is a healthcare organization registered as an interventional pain medicine in Elkin, North Carolina and active in the NPI registry since July 2006. The organization maintains 2 additional practice locations and lists Emidio Michael Novembre, Practice Owner, as its authorized official.

NPPES Registry Identity

NPI1801813712

Entity TypeOrganization

Primary Taxonomy208VP0014X

Legal Business NameREVIVAL PAIN MANAGEMENT INC

Location Address1925 N BRIDGE ST STE 101Elkin, NC 28621-2105

Mailing Address1925 N Bridge St Ste 101Elkin, NC 28621-2105 · (336) 835-5330 · Fax (336) 835-5337

Phone(336) 835-5330

Fax(336) 835-5337

Organization SubpartNo

Authorized OfficialEmidio Michael NovembrePractice Owner · (336) 835-5330

Enumeration DateJuly 16, 2006

Last NPPES UpdateNovember 20, 20254 updates tracked since enumeration

NPPES CertifiedNovember 20, 2025

✔ NPI 1801813712 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPain Medicine · Interventional Pain MedicineAllopathic & Osteopathic Physicians

Taxonomy Code208VP0014X

Definition

Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment.

Also ListedAnesthesiology · Addiction MedicineTaxonomy 207LA0401X

Also ListedAnesthesiology · Pain MedicineTaxonomy 207LP2900X

1925 N BRIDGE ST STE 101, Elkin, NC 28621

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Secondary Practice Locations 2

Location 11909 W Park DrNorth Wilkesboro, NC 28659-3564 · Phone (336) 835-5330 · Fax (336) 835-5337

Location 2905 Rockford St Lowr LevelMount Airy, NC 27030-5323 · Phone (336) 835-5330 · Fax (336) 835-5337

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Revival Pain Management Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 3 clinicians reassign Medicare billing to Revival Pain Management Inc, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Ya Xiong, NP

Nurse Practitioner

NPI 1447043252

1925 N BRIDGE ST STE 101
Elkin, NC 28621

(336) 835-5330

✔ PECOS✔ Accepts MedicareSame address

Donna Davis, NP

Nurse Practitioner

NPI 1578543997

110 DUTCHMAN CT
Elkin, NC 28621

(336) 835-5330

✔ PECOS0.7 mi

Emidio Novembre, DO

Interventional Pain Management

NPI 1750308664

110 DUTCHMAN CT
Elkin, NC 28621

(336) 835-5330

✔ PECOS✔ Accepts Medicare0.7 mi

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 Revival Pain Management Inc's NPI number?

The NPI number for Revival Pain Management Inc is 1801813712. It was assigned to this organization in the NPPES registry on July 16, 2006.

Where is Revival Pain Management Inc located?

Revival Pain Management Inc is located at 1925 N Bridge St Ste 101, Elkin, NC 28621. The listed phone number is (336) 835-5330.

What is Revival Pain Management Inc's specialty?

The primary specialty registered for this NPI is Pain Medicine, specializing in Interventional Pain Medicine, with taxonomy code 208VP0014X.

Is Revival Pain Management Inc enrolled in Medicare?

Yes. Revival Pain Management Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Revival Pain Management Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Revival Pain Management Inc, in Interventional Pain Management and Nurse Practitioner. 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. Of these, 1 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Revival Pain Management Inc accept?

Health plans from Blue Cross and Blue Shield of NC list Revival Pain Management Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Revival Pain Management Inc was last updated on November 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.