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REVIVE BEHAVIORAL HEALTH CLINIC
NPI 1194559369
Nurse Practitioner - Psychiatric/Mental Health in Bartlett, TN

Active since August 29, 2024
5820 STAGE RD, BARTLETT, TN 38134(901) 317-7900(901) 317-7899 Get Directions Write a Review

NPPES record last updated: November 8, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Revive Behavioral Health Clinic NPPES

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

REVIVE BEHAVIORAL HEALTH CLINIC (NPI 1194559369) is a healthcare organization registered as a psychiatric/mental health in Bartlett, Tennessee and active in the NPI registry since August 2024. The organization lists Ginger Marie Williams, Manager/practitioner, as its authorized official.

NPPES Registry Identity

NPI1194559369
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameREVIVE BEHAVIORAL HEALTH CLINIC
Location Address5820 STAGE RDBartlett, TN 38134-4518
Mailing Address5820 Stage RdBartlett, TN 38134-4518 · (901) 317-7900 · Fax (901) 317-7899
Phone(901) 317-7900
Fax(901) 317-7899
Organization SubpartNo
Authorized OfficialGinger Marie WilliamsManager/practitioner · (901) 317-7900
Enumeration DateAugust 29, 2024
Last NPPES UpdateNovember 8, 2024
NPPES CertifiedOctober 17, 2024
✔ NPI 1194559369 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
5820 STAGE RD, Bartlett, TN 38134
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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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Revive Behavioral Health Clinic 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 Revive Behavioral Health Clinic, which bills Medicare for the services this clinician delivers.

Clinician (1)

Ginger Williams, CRNA, PMHNP-BC
Certified Registered Nurse Anesthetist (CRNA)
NPI 1154488328
5820 STAGE RD
Bartlett, TN 38134
(901) 317-7900
Same address

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 Revive Behavioral Health Clinic's NPI number?

The NPI number for Revive Behavioral Health Clinic is 1194559369. It was assigned to this organization in the NPPES registry on August 29, 2024.

Where is Revive Behavioral Health Clinic located?

Revive Behavioral Health Clinic is located at 5820 Stage Rd, Bartlett, TN 38134. The listed phone number is (901) 317-7900.

What is Revive Behavioral Health Clinic's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Revive Behavioral Health Clinic enrolled in Medicare?

Yes. Revive Behavioral Health Clinic is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Revive Behavioral Health Clinic?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Certified Registered Nurse Anesthetist (CRNA)) reassigns their Medicare billing to Revive Behavioral Health Clinic. 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.

When was this NPI record last updated?

The NPPES record for Revive Behavioral Health Clinic was last updated on November 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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.