Revivology
NPI 1467988832ActiveOrganization· Clinic/Center· South Jordan, UT
Clinic/Center in South Jordan, Utah, registered in NPPES in May 2017. The authorized official on file is Christopher Patrick Kelly, M.D., Medical Director/Owner.
Overview
| NPI | 1467988832 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 4, 2017 |
| Last updated in NPPES | May 4, 2017 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Clinic/Center Primary | 261Q00000X | 9258138-1205 | UT |
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) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other Clinic/Center providers in South Jordan
- 1841836855
- 1750987657
- 1932978459
- 1386150597
- 1629584834
- 1669736278
- 1902212806
- 1881524379
- 1477264182
- 1073277067
- 1083226237