Revive Skin and Wound PLLC
NPI 1144186404ActiveOrganization· Physician Assistant· Mooresville, NC
Physician Assistant in Mooresville, North Carolina, registered in NPPES in December 2025. The authorized official on file is Jennifer Marie Hull, PA-C, Owner/Provider. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1144186404 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 30, 2025 |
| Last updated in NPPES | Dec 30, 2025 |
| Certified by provider | Dec 30, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NC) |
|---|
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