Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

REVIVE HEALTH AND WELLNESS OF ARKANSAS, PLLC
NPI 1548935646
Nurse Practitioner - Family in Little Rock, AR

Q: What is Revive Health And Wellness Of Arkansas, PLLC's specialty?

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

Active since August 11, 2021

8114 CANTRELL RD STE 201, LITTLE ROCK, AR 72227(501) 779-8554(501) 222-8034 Get Directions Write a Review

NPPES record last updated: September 21, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 21, 2026, Jul 8, 2022, Aug 11, 2021 (3 updates tracked since 2021).

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About Revive Health And Wellness Of Arkansas, Pllc NPPES

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

REVIVE HEALTH AND WELLNESS OF ARKANSAS, PLLC (NPI 1548935646), doing business as Revive Lifestyle Medicine, is a healthcare organization registered as a family in Little Rock, Arkansas and active in the NPI registry since August 2021. The organization lists Lindsey Ponwith, Mng Member, as its authorized official.

NPPES Registry Identity

NPI1548935646

Entity TypeOrganization

Primary Taxonomy363LF0000X

Legal Business NameREVIVE HEALTH AND WELLNESS OF ARKANSAS, PLLC

Location Address8114 CANTRELL RD STE 201Little Rock, AR 72227-2504

Mailing Address8114 Cantrell Rd Ste 201Little Rock, AR 72227-2504 · (501) 779-8554 · Fax (888) 300-9674

Phone(501) 779-8554

Fax(501) 222-8034

Organization SubpartNo

Authorized OfficialLindsey PonwithMng Member · (501) 779-8554

Enumeration DateAugust 11, 2021

Last NPPES UpdateSeptember 21, 20263 updates tracked since enumeration

NPPES CertifiedSeptember 21, 2026

✔ NPI 1548935646 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

8114 CANTRELL RD STE 201, Little Rock, AR 72227

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Other Names 1

Doing Business AsRevive Lifestyle Medicine

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

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 Health And Wellness Of Arkansas, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 2 clinicians reassign Medicare billing to Revive Health And Wellness Of Arkansas, PLLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Lindsey Gillum, APRN

Nurse Practitioner

NPI 1104122803

8114 CANTRELL RD STE 201
Little Rock, AR 72227

(501) 779-8554

✔ PECOS✔ Accepts MedicareSame address

Jourdan Quinn, APRN

Nurse Practitioner

NPI 1174910210

11300 CANTRELL RD STE 204
Little Rock, AR 72212

(501) 228-7662

✔ PECOS✔ Accepts Medicare2.2 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 Health And Wellness Of Arkansas, PLLC's NPI number?

The NPI number for Revive Health And Wellness Of Arkansas, PLLC is 1548935646. It was assigned to this organization in the NPPES registry on August 11, 2021. The provider is doing business as Revive Lifestyle Medicine.

Where is Revive Health And Wellness Of Arkansas, PLLC located?

Revive Health And Wellness Of Arkansas, PLLC is located at 8114 Cantrell Rd Ste 201, Little Rock, AR 72227. The listed phone number is (501) 779-8554.

What is Revive Health And Wellness Of Arkansas, PLLC's specialty?

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

Is Revive Health And Wellness Of Arkansas, PLLC enrolled in Medicare?

Yes. Revive Health And Wellness Of Arkansas, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Revive Health And Wellness Of Arkansas, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Revive Health And Wellness Of Arkansas, PLLC. 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. Of these, 1 practice at this address and 2 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 Health And Wellness Of Arkansas, PLLC was last updated on September 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 29 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.