1. Home
  2. Directory
  3. Georgia
  4. Kennesaw
  5. General Practice
  6. NPI Profile

REVIVE WELLNESS OF KENNESAW LLC
NPI 1033049390
General Practice in Kennesaw, GA

Active since May 20, 2026
2819 DALLAS ST NW, KENNESAW, GA 30144(770) 401-6686 Get Directions Write a Review

NPPES record last updated: June 24, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Revive Wellness Of Kennesaw Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

REVIVE WELLNESS OF KENNESAW LLC (NPI 1033049390) is a healthcare organization registered as a general practice in Kennesaw, Georgia and active in the NPI registry since May 2026. The organization lists Julia Everheart, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1033049390
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameREVIVE WELLNESS OF KENNESAW LLC
Location Address2819 DALLAS ST NWKennesaw, GA 30144-2705
Mailing Address2819 Dallas St NwKennesaw, GA 30144-2705 · (770) 212-1425
Phone(770) 401-6686
Organization SubpartNo
Authorized OfficialJulia EverheartOffice Manager · (470) 370-9280
Enumeration DateMay 20, 2026
Last NPPES UpdateJune 24, 2026
NPPES CertifiedJune 24, 2026
✔ NPI 1033049390 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
2819 DALLAS ST NW, Kennesaw, GA 30144
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. AMANDA KOCH CPM
Midwife
2819 DALLAS ST NW
KENNESAW, GA 30144
Cobb County (470) 338-3862

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Revive Wellness Of Kennesaw LLC's NPI number?

The NPI number for Revive Wellness Of Kennesaw LLC is 1033049390. It was assigned to this organization in the NPPES registry on May 20, 2026.

Where is Revive Wellness Of Kennesaw LLC located?

Revive Wellness Of Kennesaw LLC is located at 2819 Dallas St NW, Kennesaw, GA 30144. The listed phone number is (770) 401-6686.

What is Revive Wellness Of Kennesaw LLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Revive Wellness Of Kennesaw LLC was last updated on June 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 41 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.