REVIVE MEDICAL, PLLC
NPI 1679239180
Clinic/Center - Emergency Care in El Paso, TX
NPI Status: Active since November 10, 2021
Contact Information
12285 PELLICANO DRIVE
SUITE A2
EL PASO, TX
ZIP 79936
Phone: (915) 248-4863
Fax: (855) 891-7827
- Organization
- Clinic/Center
- Emergency Care
- CLIA Number: 45D2196247
- CLIA Cert. Type: Other - TEXAS LICENSED ALS FRO
- CLIA Exp. Date: 10-14-2026
About REVIVE MEDICAL, PLLC
This page provides the complete NPI Profile along with additional information for Revive Medical, Pllc, a provider established in El Paso, Texas operating as a Clinic/center, focusing in emergency care . The healthcare provider is registered in the NPI registry with number 1679239180 assigned on November 2021. The practitioner's primary taxonomy code is 261QE0002X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The authorized official of this NPI record is Clifford Owen Janke Md (Medical Director)
- NPI
- 1679239180
- Provider Name
- REVIVE MEDICAL, PLLC
- Entity Type
- Organization
- Location Address
- 12285 PELLICANO DRIVE SUITE A2 EL PASO, TX 79936
- Location Phone
- (915) 248-4863
- Location Fax
- (855) 891-7827
- Mailing Address
- 12285 PELLICANO DRIVE SUITE A2 EL PASO, TX 79936
- Mailing Phone
- (915) 248-4863
- Mailing Fax
- (855) 891-7827
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 11-10-2021
- Last Update Date
- 12-15-2021
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Emergency Care
- Taxonomy Code
- 261QE0002X
- Type
- Ambulatory Health Care Facilities
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 251F00000X | Agencies | Home Infusion | |
| 2 | 251S00000X | Agencies | Community/Behavioral Health | |
| 3 | 261QI0500X | Ambulatory Health Care Facilities | Clinic/Center | |
| 4 | 291U00000X | Laboratories | Clinical Medical Laboratory | |
| 5 | 333300000X | Suppliers | Emergency Response System Companies | |
| 6 | 3416L0300X | Transportation Services | Ambulance | |
| 7 | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) | |
| 8 | 363LX0106X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 45D2196247
- Facility Type
- Other - TEXAS LICENSED ALS FRO
- Certificate Effective Date
- October 15, 2024
- Certificate Expiration Date
- October 14, 2026
- Laboratory Director
- CLIFFORD O. JANKE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Revive Medical, Pllc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1679239180, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 70. The final step is to find the difference between that total and the next multiple of ten (70 - 70 = 0).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 70 is 70. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1679239180, enumerated as an "organization" on November 10, 2021.
The provider is located at 12285 PELLICANO DRIVE SUITE A2 EL PASO, TX 79936 and the phone number is (915) 248-4863.
Clinic/Center with taxonomy code 261QE0002X and a focus in Emergency Care.
