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REVIVE CENTER FOR HEALTH & WELLNESS
NPI 1548917594
Nurse Practitioner - Family in Vernon, CT

Active since March 09, 2022
281 HARTFORD TPKE STE 106, VERNON, CT 06066(860) 375-2227(860) 603-5080 Get Directions Write a Review

NPPES record last updated: February 25, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jun 10, 2025, Feb 24, 2023, Mar 9, 2022 (3 updates tracked since 2022).

About Revive Center For Health & Wellness NPPES

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

REVIVE CENTER FOR HEALTH & WELLNESS (NPI 1548917594) is a healthcare organization registered as a family in Vernon, Connecticut and active in the NPI registry since March 2022. The organization lists Jennifer Maria Sousa Jerome, Nurse Practitioner, as its authorized official.

NPPES Registry Identity

NPI1548917594
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameREVIVE CENTER FOR HEALTH & WELLNESS
Location Address281 HARTFORD TPKE STE 106Vernon, CT 06066-4760
Mailing Address281 Hartford Tpke Ste 106Vernon, CT 06066-4760 · (860) 375-2227 · Fax (860) 603-5080
Phone(860) 375-2227
Fax(860) 603-5080
Organization SubpartNo
Authorized OfficialJennifer Maria Sousa JeromeNurse Practitioner · (860) 375-2227
Enumeration DateMarch 9, 2022
Last NPPES UpdateFebruary 25, 20263 updates tracked since enumeration
NPPES CertifiedFebruary 25, 2026
✔ NPI 1548917594 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
281 HARTFORD TPKE STE 106, Vernon, CT 06066
Open in Google Maps ↗

Other Identifiers 1

Medicaid1134661531CT

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

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 07D2263811

Revive Center For Health & Wellness · Vernon, CT
Expired · Jul 5, 2026
CLIA Number07D2263811
Laboratory TypePractitioner Other
Certificate Effective DateJuly 6, 2024
Certificate Expiration DateJuly 5, 2026
Laboratory DirectorJennifer M. Jerome
Laboratory Phone(860) 748-7948
Laboratory LocationRevive Center For Health & Wellness281 Hartford Tnpk, Ste 106, Vernon, CT 06066
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

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

JENNIFER MARIA SOUSA JEROME APRN
Nurse Practitioner (Family)
281 HARTFORD TPKE STE 106
VERNON, CT 06066
Capitol Planning Region (860) 375-2227
RELIEVE BEHAVIORAL HEALTH AND WELLNESS LLC
Nurse Practitioner (Psychiatric/Mental Health)
281 HARTFORD TPKE STE 106
VERNON, CT 06066
Capitol Planning Region (860) 836-2174
SEEDS OF HEALING PSYCHIATRY
Nurse Practitioner (Psychiatric/Mental Health)
281 HARTFORD TPKE STE 106
VERNON, CT 06066
Capitol Planning Region (860) 997-6411
IRENE A FLYNN-LOMBARDI NP
Nurse Practitioner (Psychiatric/Mental Health)
281 HARTFORD TPKE STE 106
VERNON, CT 06066
Capitol Planning Region (860) 218-9916
JENNIFER RUTH PARADIS LCSW
Social Worker (Clinical)
281 HARTFORD TPKE STE 106
VERNON, CT 06066
Capitol Planning Region (347) 570-0242
KAMELLANN MACALOU-DRAME
Marriage & Family Therapist
281 HARTFORD TPKE STE 106
VERNON, CT 06066
Capitol Planning Region (860) 494-3800

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 Center For Health & Wellness's NPI number?

The NPI number for Revive Center For Health & Wellness is 1548917594. It was assigned to this organization in the NPPES registry on March 9, 2022.

Where is Revive Center For Health & Wellness located?

Revive Center For Health & Wellness is located at 281 Hartford Tpke Ste 106, Vernon, CT 06066. The listed phone number is (860) 375-2227.

What is Revive Center For Health & Wellness's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Revive Center For Health & Wellness was last updated on February 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.