Revivewave Therapeutics LLC
NPI 1902724776ActiveOrganization· Nurse Practitioner, Family· Olive Branch, MS
Nurse Practitioner, Family in Olive Branch, Mississippi, registered in NPPES in July 2026. The authorized official on file is Jack Chandler Papa, MSN, APRN, FNP-C, Owner / Founder.
Overview
| NPI | 1902724776 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 8, 2026 |
| Last updated in NPPES | Jul 8, 2026 |
| Certified by provider | Jul 8, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | — | — |
| Nurse Practitioner, Psych/Mental Health | 363LP0808X | — | — |
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 |
|---|
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