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

Revive Orthopedics Spine & Sports Medicine, Inc

Organization Orthopaedic Surgery Physician · NPI 1306563663

Revive Orthopedics Spine & Sports Medicine, Inc is an Orthopaedic Surgery Physician in Lithia Springs, Georgia. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
5
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

939 Bob Arnold Blvd Ste A
Lithia Springs, GA 30122-3258
Phone: (770) 209-9913
Fax: (678) 902-8579
Show map & directions

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

Specialties & licences

Multi-Specialty Clinic/Center (primary) Taxonomy 261QM1300X
Orthopaedic Surgery Physician Taxonomy 207X00000X
Sports Medicine (Orthopaedic Surgery) Physician Taxonomy 207XX0005X
Physical Medicine & Rehabilitation Physician Taxonomy 208100000X
Pain Medicine (Physical Medicine & Rehabilitation) Physician Taxonomy 2081P2900X

Record details

NPI number1306563663
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Shevin Pollydore — Physician/Owner · (770) 209-9913
Other names Revive Orthopedics Spine & Sports Medicine
NPI enumeratedOctober 26, 2022
Last updated in NPPESOctober 26, 2022
Certification dateOctober 26, 2022
Mailing address939 Bob Arnold Blvd Ste A, Lithia Springs, GA 30122-3258

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