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REVIVE LIFESTYLE MEDICINE
NPI 1548935646
Nurse Practitioner - Family in Little Rock, AR

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: July 8, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 8, 2022, Aug 11, 2021 (2 updates tracked since 2021).

About Revive Lifestyle Medicine NPPES

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

REVIVE LIFESTYLE MEDICINE (NPI 1548935646) 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 Gillum, 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 (501) 222-8034
Phone(501) 779-8554
Fax(501) 222-8034
Organization SubpartNo
Authorized OfficialLindsey GillumMng Member · (501) 779-8554
Enumeration DateAugust 11, 2021
Last NPPES UpdateJuly 8, 20222 updates tracked since enumeration
NPPES CertifiedJuly 8, 2022
✔ 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

Other Providers at the Same Location NPPES

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

MRS. LINDSEY JANE PONWITH APRN
Nurse Practitioner (Family)
8114 CANTRELL RD STE 201
LITTLE ROCK, AR 72227
Pulaski County (501) 779-8554

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.

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.

When was this NPI record last updated?

The NPPES record for Revive Health And Wellness Of Arkansas, PLLC was last updated on July 8, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.