REVIVE BEHAVIORAL HEALTH, LLC
NPI 1003601220
Nurse Practitioner - Psychiatric/Mental Health in Mount Vernon, OH
NPI Status: Active since April 09, 2025
Contact Information
206 S MULBERRY ST STE A
MOUNT VERNON, OH
ZIP 43050
Phone: (740) 501-4836
- Organization
- Nurse Practitioner
- Psychiatric/Mental Health
- Accepts Insurance
- CLIA Number: 36D2326643
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 07-07-2027
About REVIVE BEHAVIORAL HEALTH, LLC
This page provides the complete NPI Profile along with additional information for Revive Behavioral Health, Llc, a provider established in Mount Vernon, Ohio operating as a Nurse Practitioner, focusing in psychiatric/mental health . The healthcare provider is registered in the NPI registry with number 1003601220 assigned on April 2025. The practitioner's primary taxonomy code is 363LP0808X. The provider is registered as an organization and their NPI record was last updated one year ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Jordan R Moore Aprn-cnp (Owner)
- NPI
- 1003601220
- Provider Name
- REVIVE BEHAVIORAL HEALTH, LLC
- Entity Type
- Organization
- Location Address
- 206 S MULBERRY ST STE A MOUNT VERNON, OH 43050
- Location Phone
- (740) 501-4836
- Mailing Address
- 6130 SHARP RD MOUNT VERNON, OH 43050
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 04-09-2025
- Last Update Date
- 04-10-2025
- Code Navigator
A nurse practitioner (NP) like Revive Behavioral Health, Llc is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nurse Practitioner Psychiatric/Mental Health
- Taxonomy Code
- 363LP0808X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Clear Gold - HMO
- Clear Gold + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Clear Silver - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Anthem Bronze Pathway 10600 ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway 10600 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Bronze Pathway 8500 for HSA - HMO
- Anthem Gold Pathway 2000 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Heart Healthy Bronze Pathway 6000 ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Heart Healthy Silver Pathway 5000 ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Silver Pathway 4000 ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Silver Pathway 4000 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs) - HMO
- Anthem Silver Pathway 5500 for HSA - HMO
- Anthem Silver Pathway 6000 Standard ($0 Virtual PCP + $0 Select Drugs) - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 36D2326643
- Facility Type
- Physician Office
- Certificate Effective Date
- July 08, 2025
- Certificate Expiration Date
- July 07, 2027
- Laboratory Director
- JORDAN R. MOORE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Revive Behavioral Health, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1003601220, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 40. The final step is to find the difference between that total and the next multiple of ten (40 - 40 = 0).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 40 is 40. The difference is the calculated check digit.
Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
MOUNT VERNON, OH 43050
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1003601220, enumerated as an "organization" on April 09, 2025.
The provider is located at 206 S MULBERRY ST STE A MOUNT VERNON, OH 43050 and the phone number is (740) 501-4836.
Nurse Practitioner with taxonomy code 363LP0808X and a focus in Psychiatric/Mental Health.
The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter from. Please consult your insurance carrier or call the provider to verify.
