REVIVE MD NPI 1700107547

NPI Information

  • NPI: 1700107547
  • Provider Name: REVIVE MD
  • Classification: Obstetrics & Gynecology - 207VB0002X
  • Specialization: Obesity Medicine
  • Entity Type: Organization
  • Doing Business As: BLUESKY MD
  • Address: 1804 WILLIAMSON CT
    SUITE 107
    BRENTWOOD, TN
    ZIP 37027
  • Phone: (615) 690-6600

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NPI Details

REVIVE MD is an obesity medicine obstetrics gynecology in Brentwood, TN. The provider is an obstetrics & gynecology physician who specializes in the treatment of obesity demonstrates competency in and a thorough understanding of the treatment of obesity and the genetic, biologic, environmental, social, and behavioral factors that contribute to obesity. The obesity medicine physician employs therapeutic interventions including diet, physical activity, behavioral change, and pharmacotherapy. The obesity medicine physician utilizes a comprehensive approach, and may include additional resources such as dietitians, exercise physiologists, mental health professionals and bariatric surgeons as indicated to achieve optimal results. Additionally, the obesity medicine physician maintains competency in providing pre- peri- and post-surgical care of bariatric surgery patients, promotes the prevention of obesity, and advocates for those who suffer from obesity. REVIVE MD NPI is 1700107547. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Bluesky Md.

The provider's business location address is:

1804 WILLIAMSON CT
SUITE 107
BRENTWOOD, TN
ZIP 37027-170
Phone: (615) 690-6600
Fax: (615) 690-6604

The provider's authorized official is Daphne Baker Lodge .
The authorized official title is President and has the following contact phone number (615) 690-6600.

The enumeration date for this NPI number is 6/16/2010 and was last updated on 6/16/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207VB0002XObstetrics & GynecologyObesity Medicine26575TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1F38598MEDICARE UPINTENNESSEE

What is NPI?

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This page was last updated on: 3/30/2025

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