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

Revive Orthopedics Spine & Sports Medicine, Inc

Organization Orthopaedic Surgery Physician · NPI 1629765433

Revive Orthopedics Spine & Sports Medicine, Inc is an Orthopaedic Surgery Physician in Stockbridge, Georgia. Registered with an NPI since 2023.

In the registry since
2023
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

218 Willis Dr
Stockbridge, GA 30281-7272
Phone: (770) 769-1724
Fax: (770) 708-6599
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthopaedic Surgery Physician (primary) Taxonomy 207X00000X
Physical Medicine & Rehabilitation Physician Taxonomy 208100000X
Pain Medicine (Physical Medicine & Rehabilitation) Physician Taxonomy 2081P2900X
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X
Pharmacy Taxonomy 333600000X

Record details

NPI number1629765433
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Shevin Pollydore — Owner · (770) 769-1724
Other names Revive Orthopedics Spine & Sports Medicine; Revive Orthopedics Spine & Sports Medicine
NPI enumeratedApril 20, 2023
Last updated in NPPESAugust 17, 2025
Certification dateAugust 17, 2025
Mailing address939 Bob Arnold Blvd Ste A, Lithia Springs, GA 30122-3258

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