Revive Medical Center LLC
NPI 1740996636ActiveOrganization· Family Medicine· Haleyville, AL
Family Medicine in Haleyville, Alabama, registered in NPPES in January 2023. The authorized official on file is Larry Jake Pickens, Owner/President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1740996636 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 25, 2023 |
| Last updated in NPPES | Feb 22, 2023 |
| Certified by provider | Feb 22, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
| Clinic/Center, Urgent Care | 261QU0200X | — | — |
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 (AL) |
|---|
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