REVIVE FUNCTIONAL REHABILITATION CENTER
NPI 1619770005
Clinic/Center - Pain in Tampa, FL
About Revive Functional Rehabilitation Center NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
REVIVE FUNCTIONAL REHABILITATION CENTER (NPI 1619770005) is a healthcare organization registered as a pain in Tampa, Florida and active in the NPI registry since March 2025. The organization lists David E Fairleigh, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
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 Functional Rehabilitation Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Revive Functional Rehabilitation Center, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 Functional Rehabilitation Center's NPI number?
The NPI number for Revive Functional Rehabilitation Center is 1619770005. It was assigned to this organization in the NPPES registry on March 31, 2025.
Where is Revive Functional Rehabilitation Center located?
Revive Functional Rehabilitation Center is located at 3246 Cove Bend Dr, Tampa, FL 33613. The listed phone number is (850) 291-3618.
What is Revive Functional Rehabilitation Center's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Pain, with taxonomy code 261QP3300X.
Is Revive Functional Rehabilitation Center enrolled in Medicare?
Yes. Revive Functional Rehabilitation Center is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Revive Functional Rehabilitation Center?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Anesthesiology) reassigns their Medicare billing to Revive Functional Rehabilitation Center. 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. 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 Functional Rehabilitation Center was last updated on March 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# Revive Functional Rehabilitation Center · NPI 1619770005
Pain organization in Tampa, Florida. Organization record, active in the CMS NPPES registry since March 31, 2025.
## Identity
- **NPI:** 1619770005 (Entity type: Organization)
- **Enumerated:** March 31, 2025
- **Primary specialty:** Clinic/Center - Pain · taxonomy 261QP3300X
- **Organization subpart:** No
- **Authorized official:** David Fairleigh, OWNER
## Practice location
- **Address:** 3246 COVE BEND DR, Tampa, FL 33613-2752
- **Phone:** (850) 291-3618
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Anesthesiology) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 31, 2025
---
Source: [NPI Profile](https://npiprofile.com/npi/1619770005) · Data from the CMS NPPES public registry.