REVIVE COMMUNITY HEALTH
NPI 1255916987
Registered Nurse - Wound Care in Tempe, AZ
About Revive Community Health NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
REVIVE COMMUNITY HEALTH (NPI 1255916987) is a healthcare organization registered as a wound care in Tempe, Arizona and active in the NPI registry since March 2021. The organization holds a CLIA Waiver certificate valid through January 11, 2027, maintains a secondary practice location in Tucson, and lists Micah Phillips, Coo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 5
Other Names 2
Secondary Practice Location 1
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)
Revive Community Health is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
5Medicare enrollment records show 5 clinicians reassign Medicare billing to Revive Community Health, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (5)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 03D2209294
Revive Community Health · Tempe, AZFrequently 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 Community Health's NPI number?
The NPI number for Revive Community Health is 1255916987. It was assigned to this organization in the NPPES registry on March 15, 2021. The provider is doing business as Revive Community Health LLC.
Where is Revive Community Health located?
Revive Community Health is located at 4700 S Mcclintock Dr Ste 140, Tempe, AZ 85282. The listed phone number is (480) 851-6309.
What is Revive Community Health's specialty?
The primary specialty registered for this NPI is Registered Nurse, specializing in Wound Care, with taxonomy code 163WW0000X.
Is Revive Community Health enrolled in Medicare?
Yes. Revive Community Health is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Revive Community Health?
According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 3 Medicare specialties reassign their Medicare billing to Revive Community Health. 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 (3), Family Practice (1) and General Surgery (1). Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Revive Community Health hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 03D2209294) is associated with this NPI, valid through January 11, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Revive Community Health accept?
Health plans from Ambetter from Arizona Complete Health list Revive Community Health 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 Community Health was last updated on August 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 54 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.
# Revive Community Health · NPI 1255916987
Wound Care organization in Tempe, Arizona. Organization record, active in the CMS NPPES registry since March 15, 2021.
## Identity
- **NPI:** 1255916987 (Entity type: Organization)
- **Enumerated:** March 15, 2021
- **Primary specialty:** Registered Nurse - Wound Care · taxonomy 163WW0000X
- **Also known as:** Revive Community Health (Doing Business As); Revive Community Health LLC (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Micah Phillips, COO
## Practice location
- **Address:** 4700 S MCCLINTOCK DR STE 140, Tempe, AZ 85282-7375
- **Phone:** (480) 851-6309
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 5 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (3), Family Practice (1), General Surgery (1); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 27, 2026
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1255916987) · Data from the CMS NPPES public registry.