REVIVE SPORT & SPINE
NPI 1649646969
Chiropractor - Sports Physician in Murray, UT

Q: What is Revive Sport & Spine's NPI number?

The NPI number for Revive Sport & Spine is 1649646969. It was assigned to this organization in the NPPES registry on August 20, 2015.

Q: What is Revive Sport & Spine's specialty?

The primary specialty registered for this NPI is Chiropractor, specializing in Sports Physician, with taxonomy code 111NS0005X.

Active since August 20, 2015

1996 E 6400 S STE 260, MURRAY, UT 84121(801) 944-1855(385) 351-5950 Get Directions Write a Review

NPPES record last updated: October 9, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 9, 2025, Oct 1, 2020 (2 updates tracked since 2020).

On this page

About Revive Sport & Spine NPPES

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

REVIVE SPORT & SPINE (NPI 1649646969) is a healthcare organization registered as a sports physician in Murray, Utah and active in the NPI registry since August 2015. The organization lists Andrew J Reheisse, Owner, as its authorized official.

NPPES Registry Identity

NPI1649646969

Entity TypeOrganization

Primary Taxonomy111NS0005X

Legal Business NameREVIVE SPORT & SPINE

Location Address1996 E 6400 S STE 260Murray, UT 84121-2173

Mailing Address1996 E 6400 S Ste 260Murray, UT 84121-2173 · (801) 944-1855 · Fax (385) 351-5950

Phone(801) 944-1855

Fax(385) 351-5950

Organization SubpartNo

Authorized OfficialAndrew J ReheisseOwner · (801) 944-1855

Enumeration DateAugust 20, 2015

Last NPPES UpdateOctober 9, 20252 updates tracked since enumeration

NPPES CertifiedOctober 9, 2025

✔ NPI 1649646969 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyChiropractor · Sports PhysicianChiropractic Providers

Taxonomy Code111NS0005X

License✔ Licensed in UT · 91235421202

Definition

A sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) or the Certified Chiropractic Sports Physician (CCSP), sport specialty certifications from the American Chiropractic Board of Sports Physicians, have advanced training in the assessment, management and rehabilitation of sports related injuries. Extremity care, rehabilitation and soft tissue procedures are common skills utilized by these doctors. The specialty training covers a broad spectrum from the pediatric athlete to professional and Olympic athletes, and everything in between, using a variety of techniques and modalities.

Also ListedChiropractorTaxonomy 111N00000X · License 91235421202 (UT)

1996 E 6400 S STE 260, Murray, UT 84121

Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Regence BlueCross BlueShield of Utah, University of Utah Health Plans.Insurance ›

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 Sport & Spine 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 Sport & Spine, which bills Medicare for the services this clinician delivers.

Clinician (1)

Andrew Reheisse, D.C.

Chiropractic

NPI 1003217449

1996 E 6400 S STE 260
Murray, UT 84121

(801) 944-1855

✔ Accepts MedicareSame address

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 Sport & Spine's NPI number?

The NPI number for Revive Sport & Spine is 1649646969. It was assigned to this organization in the NPPES registry on August 20, 2015.

Where is Revive Sport & Spine located?

Revive Sport & Spine is located at 1996 E 6400 S Ste 260, Murray, UT 84121. The listed phone number is (801) 944-1855.

What is Revive Sport & Spine's specialty?

The primary specialty registered for this NPI is Chiropractor, specializing in Sports Physician, with taxonomy code 111NS0005X.

Is Revive Sport & Spine enrolled in Medicare?

Yes. Revive Sport & Spine is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Revive Sport & Spine?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to Revive Sport & Spine. 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.

What insurance does Revive Sport & Spine accept?

Health plans from BridgeSpan Health Company, Regence BlueCross BlueShield of Utah and University of Utah Health Plans list Revive Sport & Spine 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 Sport & Spine was last updated on October 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.