Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Revival Pain Management Inc

Organization Addiction Medicine (Anesthesiology) Physician · NPI 1801813712

Revival Pain Management Inc is an Addiction Medicine (Anesthesiology) Physician in Elkin, North Carolina. Works from 3 locations. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
3
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1925 N Bridge St Ste 101
Elkin, NC 28621-2105
Phone: (336) 835-5330
Fax: (336) 835-5337
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 905 Rockford St Lowr Level, Mount Airy, NC 27030-5323 — (336) 835-5330
  • 1909 W Park Dr, North Wilkesboro, NC 28659-3564 — (336) 835-5330

Specialties & licences

Interventional Pain Medicine Physician (primary) Taxonomy 208VP0014X
Addiction Medicine (Anesthesiology) Physician Taxonomy 207LA0401X
Pain Medicine (Anesthesiology) Physician Taxonomy 207LP2900X

Record details

NPI number1801813712
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Emidio Novembre — Practice Owner · (336) 835-5330
NPI enumeratedJuly 16, 2006
Last updated in NPPESNovember 20, 2025
Certification dateNovember 20, 2025
Mailing address1925 N Bridge St Ste 101, Elkin, NC 28621-2105

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