Revive Community Health
NPI 1255916987ActiveOrganization· Registered Nurse, Wound Care· Tempe, AZ
Registered Nurse, Wound Care in Tempe, Arizona, registered in NPPES in March 2021. The authorized official on file is Micah Phillips, Coo. Enrolled in Medicare as part b supplier - clinic/group practice and part b supplier - clinic/group practice.
Overview
| NPI | 1255916987 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 15, 2021 |
| Last updated in NPPES | Aug 27, 2026 |
| Certified by provider | Aug 27, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Registered Nurse, Wound Care Primary | 163WW0000X | — | — |
| Family Medicine | 207Q00000X | — | — |
| Surgery | 208600000X | — | — |
| Clinic/Center, Medical Specialty | 261QM2500X | — | — |
| Nurse Practitioner | 363L00000X | — | — |
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); Part B Supplier - Clinic/Group Practice (TX) |
|---|
Other Registered Nurse, Wound Care providers in Tempe
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