REVITALIZED WELLNESS
NPI 1104682590
Nurse Practitioner - Psychiatric/Mental Health in Duncanville, TX
About Revitalized Wellness NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
REVITALIZED WELLNESS (NPI 1104682590) is a healthcare organization registered as a psychiatric/mental health in Duncanville, Texas and active in the NPI registry since February 2024. The organization lists Charmeka Lipscomb, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Revitalized Wellness is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Revitalized Wellness, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 Revitalized Wellness's NPI number?
The NPI number for Revitalized Wellness is 1104682590. It was assigned to this organization in the NPPES registry on February 23, 2024.
Where is Revitalized Wellness located?
Revitalized Wellness is located at 1043 Meadow Run Dr, Duncanville, TX 75137. The listed phone number is (972) 838-0652.
What is Revitalized Wellness's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Revitalized Wellness enrolled in Medicare?
Yes. Revitalized Wellness is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Revitalized Wellness?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Revitalized Wellness. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Revitalized Wellness accept?
Health plans from Blue Cross and Blue Shield of Texas and Molina Healthcare list Revitalized Wellness as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Revitalized Wellness was last updated on February 23, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Revitalized Wellness · NPI 1104682590
Psychiatric/Mental Health organization in Duncanville, Texas. Organization record, active in the CMS NPPES registry since February 23, 2024.
## Identity
- **NPI:** 1104682590 (Entity type: Organization)
- **Enumerated:** February 23, 2024
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Charmeka Lipscomb, OWNER
## Practice location
- **Address:** 1043 MEADOW RUN DR, Duncanville, TX 75137-3599
- **Phone:** (972) 838-0652
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 23, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1104682590) · Data from the CMS NPPES public registry.