REVIVE WELLNESS AND AESTHETICS
NPI 1548940752
Nurse Practitioner - Family in Eagle, ID

Q: What is Revive Wellness And Aesthetics's NPI number?

The NPI number for Revive Wellness And Aesthetics is 1548940752. It was assigned to this organization in the NPPES registry on July 21, 2023.

Q: What is Revive Wellness And Aesthetics's specialty?

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

Active since July 21, 2023

445 S FITNESS PL # 130, EAGLE, ID 83616(208) 939-2332 Get Directions Write a Review

NPPES record last updated: July 21, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Revive Wellness And Aesthetics NPPES

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

REVIVE WELLNESS AND AESTHETICS (NPI 1548940752) is a healthcare organization registered as a family in Eagle, Idaho and active in the NPI registry since July 2023. The organization lists Kelsey Martin, Owner/nurse Practitioner, as its authorized official.

NPPES Registry Identity

NPI1548940752

Entity TypeOrganization

Primary Taxonomy363LF0000X

Legal Business NameREVIVE WELLNESS AND AESTHETICS

Location Address445 S FITNESS PL # 130Eagle, ID 83616-6828

Mailing Address4253 N Sorrel PlBoise, ID 83703-3487

Phone(208) 939-2332

Organization SubpartNo

Authorized OfficialKelsey MartinOwner/nurse Practitioner · (217) 617-2575

Enumeration DateJuly 21, 2023

NPPES CertifiedJuly 21, 2023

✔ NPI 1548940752 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

445 S FITNESS PL # 130, Eagle, ID 83616

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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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..Insurance ›

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 Wellness And Aesthetics's NPI number?

The NPI number for Revive Wellness And Aesthetics is 1548940752. It was assigned to this organization in the NPPES registry on July 21, 2023.

Where is Revive Wellness And Aesthetics located?

Revive Wellness And Aesthetics is located at 445 S Fitness Pl # 130, Eagle, ID 83616. The listed phone number is (208) 939-2332.

What is Revive Wellness And Aesthetics's specialty?

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

What insurance does Revive Wellness And Aesthetics accept?

Health plans from Moda Health Plan, Inc. list Revive Wellness And Aesthetics as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Revive Wellness And Aesthetics was last updated on July 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.