Revive Clinic and Spa
NPI 1205479888ActiveOrganization· Nurse Practitioner, Family· Ankeny, IA
Nurse Practitioner, Family in Ankeny, Iowa, registered in NPPES in October 2019. The authorized official on file is Stefanie Gatica, DNP, FNP-C, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1205479888 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 25, 2019 |
| Last updated in NPPES | Aug 14, 2024 |
| Certified by provider | Aug 14, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | — | — |
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 (IA) |
|---|
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