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REVIVAL HEALTH AND WELLNESS CLINIC
NPI 1366241507
Family Medicine in Salem, IL

Active since March 11, 2025
207 E MAIN ST, SALEM, IL 62881(706) 889-8349 Get Directions Write a Review

NPPES record last updated: June 27, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 27, 2025, Mar 11, 2025 (2 updates tracked since 2025).

About Revival Health And Wellness Clinic NPPES

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

REVIVAL HEALTH AND WELLNESS CLINIC (NPI 1366241507) is a healthcare organization registered as a family medicine in Salem, Illinois and active in the NPI registry since March 2025. The organization lists Crea Rose, Owner/ Provider, as its authorized official.

NPPES Registry Identity

NPI1366241507
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameREVIVAL HEALTH AND WELLNESS CLINIC
Location Address207 E MAIN STSalem, IL 62881-2926
Mailing Address1602 Woods LnCentralia, IL 62801-6774
Phone(706) 889-8349
Organization SubpartNo
Authorized OfficialCrea RoseOwner/ Provider · (706) 889-8349
Enumeration DateMarch 11, 2025
Last NPPES UpdateJune 27, 20252 updates tracked since enumeration
NPPES CertifiedJune 27, 2025
✔ NPI 1366241507 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
207 E MAIN ST, Salem, IL 62881
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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

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHRISTINA MARIE WEIBLEY FNP-C, FPA
Nurse Practitioner (Family)
207 E MAIN ST
SALEM, IL 62881
Marion County (618) 740-2240
CREA ROSE
Nurse Practitioner
207 E MAIN ST
SALEM, IL 62881
Marion County (618) 740-2240

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 Revival Health And Wellness Clinic's NPI number?

The NPI number for Revival Health And Wellness Clinic is 1366241507. It was assigned to this organization in the NPPES registry on March 11, 2025.

Where is Revival Health And Wellness Clinic located?

Revival Health And Wellness Clinic is located at 207 E Main St, Salem, IL 62881. The listed phone number is (706) 889-8349.

What is Revival Health And Wellness Clinic's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Revival Health And Wellness Clinic was last updated on June 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.