REVIVE WELLNESS AND BEAUTY, LLC
NPI 1265230148
Nurse Practitioner - Family in San Tan Valley, AZ
About Revive Wellness And Beauty, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
REVIVE WELLNESS AND BEAUTY, LLC (NPI 1265230148) is a healthcare organization registered as a family in San Tan Valley, Arizona and active in the NPI registry since March 2025. The organization lists Kristina Mckinzie, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
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 Wellness And Beauty, Llc 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 Wellness And Beauty, LLC, 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 Revive Wellness And Beauty, LLC's NPI number?
The NPI number for Revive Wellness And Beauty, LLC is 1265230148. It was assigned to this organization in the NPPES registry on March 5, 2025.
Where is Revive Wellness And Beauty, LLC located?
Revive Wellness And Beauty, LLC is located at 10593 E American Pride Dr, San Tan Valley, AZ 85143. The listed phone number is (619) 201-0835.
What is Revive Wellness And Beauty, LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Revive Wellness And Beauty, LLC enrolled in Medicare?
Yes. Revive Wellness And Beauty, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Revive Wellness And Beauty, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Revive Wellness And Beauty, LLC. 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 Wellness And Beauty, LLC was last updated on March 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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 Wellness And Beauty, Llc · NPI 1265230148
Family organization in San Tan Valley, Arizona. Organization record, active in the CMS NPPES registry since March 5, 2025.
## Identity
- **NPI:** 1265230148 (Entity type: Organization)
- **Enumerated:** March 5, 2025
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Kristina Mckinzie, OWNER
## Practice location
- **Address:** 10593 E AMERICAN PRIDE DR, San Tan Valley, AZ 85143-7978
- **Phone:** (619) 201-0835
## 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:** March 5, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1265230148) · Data from the CMS NPPES public registry.