REVIVAL PSYCHIATRY
NPI 1073285987
Nurse Practitioner - Psychiatric/Mental Health in Athens, AL
About Revival Psychiatry NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
REVIVAL PSYCHIATRY (NPI 1073285987) is a healthcare organization registered as a psychiatric/mental health in Athens, Alabama and active in the NPI registry since September 2021. The organization lists Jacob Scott, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Revival Psychiatry is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by November 30, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
5Medicare enrollment records show 5 clinicians reassign Medicare billing to Revival Psychiatry, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (5)
Colorado Springs, CO 80917
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Revival Psychiatry's NPI number?
The NPI number for Revival Psychiatry is 1073285987. It was assigned to this organization in the NPPES registry on September 29, 2021.
Where is Revival Psychiatry located?
Revival Psychiatry is located at 15884 E Limestone Rd, Athens, AL 35613. The listed phone number is (256) 431-6469.
What is Revival Psychiatry's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Revival Psychiatry enrolled in Medicare?
Yes. Revival Psychiatry is registered in the Medicare PECOS enrollment system.
When is Revival Psychiatry's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Alabama, Clinic/Group Practice) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Revival Psychiatry?
According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Revival Psychiatry. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (4) and Clinical Social Worker (1). Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Revival Psychiatry was last updated on September 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.
# Revival Psychiatry · NPI 1073285987
Psychiatric/Mental Health organization in Athens, Alabama. Organization record, active in the CMS NPPES registry since September 29, 2021.
## Identity
- **NPI:** 1073285987 (Entity type: Organization)
- **Enumerated:** September 29, 2021
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Jacob Scott, OWNER
## Practice location
- **Address:** 15884 E LIMESTONE RD, Athens, AL 35613-7522
- **Phone:** (256) 431-6469
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** November 30, 2026 (Non-DME Part B, Alabama, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 5 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (4), Clinical Social Worker (1); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 29, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1073285987) · Data from the CMS NPPES public registry.