Revajo Broadwater, PT
NPI 1023111317 · Physical Therapist · Valdosta, GA
Enrolled with Medicare as Practitioner - Physical Therapist in Private Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Revajo Broadwater, PT is a Physical Therapist provider in Valdosta, GA (NPI 1023111317).
Provider details
- NPI number
- 1023111317
- Entity type
- Individual
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- PT
- Sex
- Female
- Sole proprietor
- No
- License
- 1473 (GA)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
19 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
1,593 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Therapy Procedure Using Exercise to Develop Strength, Endurance, Range of Motion, and Flexibility, Each 15 Minutes97110 | 905 | $21 |
| Therapy Procedure to Re-Educate Brain-To-Nerve-To-Muscle Function, Each 15 Minutes97112 | 556 | $29 |
| Therapy Procedure Using Functional Activities97530 | 83 | $29 |
| Evaluation for Physical Therapy, Typically 20 Minutes97161 | 49 | $93 |
Typical Medicare-allowed amounts for these services range $21–$93 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-09-05
- Last updated
- 2007-07-08
Frequently asked questions
- What is Revajo Broadwater's NPI number?
- Revajo Broadwater's National Provider Identifier (NPI) is 1023111317, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Revajo Broadwater's specialty?
- Revajo Broadwater is listed in the NPPES registry with a primary specialty of Physical Therapist (Respiratory, Developmental, Rehabilitative and Restorative Service Providers).
- Where is Revajo Broadwater located?
- Revajo Broadwater's practice location on file with NPPES is 3537 North Crossing Circle, Valdosta, GA 31602.
- What is Revajo Broadwater's phone number?
- The practice phone number listed in the NPPES registry for Revajo Broadwater is (229) 333-0095.
- Does Revajo Broadwater accept Medicare?
- Revajo Broadwater is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Revajo Broadwater's NPI active?
- Yes — Revajo Broadwater's NPI (1023111317) is active in the NPPES registry as of the last update on 2007-07-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.