REVIVE & THRIVE MENTAL HEALTH, LLC
NPI 1356003628
Nurse Practitioner - Psychiatric/Mental Health in Wichita, KS

Q: What is Revive & Thrive Mental Health, LLC's NPI number?

The NPI number for Revive & Thrive Mental Health, LLC is 1356003628. It was assigned to this organization in the NPPES registry on October 13, 2021.

Q: What is Revive & Thrive Mental Health, LLC's specialty?

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

Active since October 13, 2021

4013 N RIDGE RD STE 110, WICHITA, KS 67205(316) 631-2454(316) 247-6062 Get Directions Write a Review

NPPES record last updated: July 7, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 7, 2024, May 10, 2023, Mar 7, 2023 and 1 more (4 updates tracked since 2021).

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About Revive & Thrive Mental Health, Llc NPPES

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

REVIVE & THRIVE MENTAL HEALTH, LLC (NPI 1356003628) is a healthcare organization registered as a psychiatric/mental health in Wichita, Kansas and active in the NPI registry since October 2021. The organization lists Evangeline Newsom, Owner, as its authorized official.

NPPES Registry Identity

NPI1356003628

Entity TypeOrganization

Primary Taxonomy363LP0808X

Legal Business NameREVIVE & THRIVE MENTAL HEALTH, LLC

Location Address4013 N RIDGE RD STE 110Wichita, KS 67205-8859

Mailing Address4013 N Ridge Rd Ste 110Wichita, KS 67205-8859 · (316) 201-6294 · Fax (316) 364-3020

Phone(316) 631-2454

Fax(316) 247-6062

Organization SubpartNo

Authorized OfficialEvangeline NewsomOwner · (316) 201-6294

Enumeration DateOctober 13, 2021

Last NPPES UpdateJuly 7, 20244 updates tracked since enumeration

NPPES CertifiedJuly 7, 2024

✔ NPI 1356003628 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 15

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X

Also ListedCounselor · ProfessionalTaxonomy 101YP2500X

Also ListedPsychologistTaxonomy 103T00000X

Also ListedPsychologist · Cognitive & BehavioralTaxonomy 103TB0200X

Also ListedPsychologist · ClinicalTaxonomy 103TC0700X

Also ListedPsychologist · CounselingTaxonomy 103TC1900X

Also ListedPsychologist · Clinical Child & AdolescentTaxonomy 103TC2200X

Also ListedSocial WorkerTaxonomy 104100000X

Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X

Also ListedMarriage & Family TherapistTaxonomy 106H00000X

Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X

Also ListedClinic/Center · Adult Mental HealthTaxonomy 261QM0850X

Also ListedClinic/Center · Adolescent and Children Mental HealthTaxonomy 261QM0855X

4013 N RIDGE RD STE 110, Wichita, KS 67205

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Other Identifiers 3

Medicaid30004830030002KS

Other363LP0808XKS · Taxonomy

Medicaid30004842030001KS

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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 & Thrive Mental Health, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 7 clinicians reassign Medicare billing to Revive & Thrive Mental Health, LLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 6 within 10 miles. They are listed nearest first.

Clinicians, nearest first (7)

Debra Morgan, F.N.P., P.M.H.N.P.

Nurse Practitioner

NPI 1568416550

4013 N RIDGE RD STE 110
Wichita, KS 67205

(316) 201-6294

✔ PECOSSame address

Jeremy Henning, LPC 04598-T.

Mental Health Counselor

NPI 1891550489

4013 N RIDGE RD STE 110
Wichita, KS 67205

(316) 201-6294

✔ PECOSSame address

Gina Sucher, LSCSW

Clinical Social Worker

NPI 1477105179

7200 W 13TH ST N STE 218
Wichita, KS 67212

(617) 549-6244

✔ PECOS3.2 mi

Carie Cagle, LPC

Mental Health Counselor

NPI 1407235450

659 N MARKET ST
Wichita, KS 67214

(316) 201-6294

✔ PECOS✔ Accepts Medicare6.5 mi

Evangeline Newsom-White, LSCSW

Clinical Social Worker

NPI 1245627033

659 N MARKET ST
Wichita, KS 67214

(316) 631-2454

✔ PECOS✔ Accepts Medicare6.5 mi

Laveta Jarrett, APRN

Nurse Practitioner

NPI 1588890404

818 N CARRIAGE PKWY
Wichita, KS 67208

(316) 651-2216

✔ PECOS✔ Accepts Medicare9.5 mi

Shannon Pelzel, LMSW

Clinical Social Worker

NPI 1326613456

720 MEDICAL CENTER DR
Newton, KS 67114

(316) 284-5170

✔ PECOS19 mi

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 & Thrive Mental Health, LLC's NPI number?

The NPI number for Revive & Thrive Mental Health, LLC is 1356003628. It was assigned to this organization in the NPPES registry on October 13, 2021.

Where is Revive & Thrive Mental Health, LLC located?

Revive & Thrive Mental Health, LLC is located at 4013 N Ridge Rd Ste 110, Wichita, KS 67205. The listed phone number is (316) 631-2454.

What is Revive & Thrive Mental Health, LLC's specialty?

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

Is Revive & Thrive Mental Health, LLC enrolled in Medicare?

Yes. Revive & Thrive Mental Health, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Revive & Thrive Mental Health, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 3 Medicare specialties reassign their Medicare billing to Revive & Thrive Mental Health, 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. The largest specialties are Clinical Social Worker (3), Mental Health Counselor (2) and Nurse Practitioner (2). Of these, 2 practice at this address and 6 within 10 miles. 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 & Thrive Mental Health, LLC was last updated on July 7, 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.