REVIVE DERMATOLOGY CLINIC AND SPA
NPI 1205479888
Nurse Practitioner - Family in Ankeny, IA
About Revive Dermatology Clinic And Spa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
REVIVE DERMATOLOGY CLINIC AND SPA (NPI 1205479888) is a healthcare organization registered as a family in Ankeny, Iowa and active in the NPI registry since October 2019. The organization holds a CLIA Waiver certificate valid through March 24, 2027 and lists Stefanie Gatica, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
Accepted Insurance
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 16D2218040
Revive Dermatology Clinic And Spa · Ankeny, IAOther Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Clinic And Spa's NPI number?
The NPI number for Revive Clinic And Spa is 1205479888. It was assigned to this organization in the NPPES registry on October 25, 2019. The provider is doing business as Revive Dermatology Clinic And Spa.
Where is Revive Clinic And Spa located?
Revive Clinic And Spa is located at 1850 SW Plaza Shops Ln Ste A, Ankeny, IA 50023. The listed phone number is (515) 965-5677.
What is Revive Clinic And Spa's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Does Revive Clinic And Spa hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 16D2218040) is associated with this NPI, valid through March 24, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Revive Clinic And Spa accept?
Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from NH Healthy Families and Ambetter from Sunflower Health Plan and 1 other insurer list Revive Clinic And Spa 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 Revive Clinic And Spa was last updated on August 14, 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.
# Revive Dermatology Clinic And Spa · NPI 1205479888
Family organization in Ankeny, Iowa. Organization record, active in the CMS NPPES registry since October 25, 2019.
## Identity
- **NPI:** 1205479888 (Entity type: Organization)
- **Enumerated:** October 25, 2019
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Legal business name:** Revive Clinic And Spa
- **Organization subpart:** No
- **Authorized official:** Stefanie Gatica, OWNER
## Practice location
- **Address:** 1850 SW PLAZA SHOPS LN STE A, Ankeny, IA 50023-7168
- **Phone:** (515) 965-5677
## Record status
- **NPPES last updated:** August 14, 2024
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1205479888) · Data from the CMS NPPES public registry.