Revived Wellness LLC
NPI 1891653523ActiveOrganization· Family Medicine· Centerville, UT
Family Medicine in Centerville, Utah, registered in NPPES in January 2026. The authorized official on file is Jonathan Barker, ADMINISTRATION, Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1891653523 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 12, 2026 |
| Last updated in NPPES | Jan 12, 2026 |
| Certified by provider | Jan 12, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
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 (UT) |
|---|
Other Family Medicine providers in Centerville
- 1326174095
- 1699179267
- 1346235793
- 1508124264
- 1144319997
- 1548252950