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Life Integrative Medicine

Psychiatry Physician in Wilmington, NC · enumerated 2019 · authorized official Jeremy Revell, Owner/Provider.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1326684259

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Registry record

Entity type Organization (Type 2)
Legal business name Life Integrative Medicine
Practice address 2018 Eastwood Rd, Wilmington, NC, 28403
Phone (910) 787-1358
Fax (910) 344-0379
Enumeration date Nov 26, 2019
Last updated in NPPES Nov 26, 2019

Taxonomy & classification

2084A0401X Addiction Medicine (Psychiatry & Neurology) Physician Allopathic & Osteopathic Physicians Secondary
2084B0002X Obesity Medicine (Psychiatry & Neurology) Physician Allopathic & Osteopathic Physicians Secondary
2084P0005X Neurodevelopmental Disabilities Physician Allopathic & Osteopathic Physicians Secondary
2084P0800X Psychiatry Physician Allopathic & Osteopathic Physicians Primary
2084P0804X Child & Adolescent Psychiatry Physician Allopathic & Osteopathic Physicians Secondary
2084P0805X Geriatric Psychiatry Physician Allopathic & Osteopathic Physicians Secondary
2084P2900X Pain Medicine (Psychiatry & Neurology) Physician Allopathic & Osteopathic Physicians Secondary
2084S0010X Sports Medicine (Psychiatry & Neurology) Physician Allopathic & Osteopathic Physicians Secondary

Authorized official

Name Jeremy Revell
Title Owner/Provider
Phone (323) 216-0993

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

What type of organization is Life Integrative Medicine?
Life Integrative Medicine is registered in NPPES as a Psychiatry Physician (its primary provider taxonomy).
What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2019-11-26.