Reviving Wellness LLC
NPI 1053159996ActiveOrganization· Nurse Practitioner, Adult Health· Gilbert, AZ
Nurse Practitioner, Adult Health in Gilbert, Arizona, registered in NPPES in July 2024. The authorized official on file is Carrie Martinson, NP, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1053159996 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 16, 2024 |
| Last updated in NPPES | Aug 23, 2024 |
| Certified by provider | Aug 20, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Adult Health Primary | 363LA2200X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (AZ) |
|---|
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