REVERED-HOLISTIC HEALTHCARE LLC
NPI 1700377876
Nurse Practitioner - Family in Columbia, MD
About Revered-holistic Healthcare Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
REVERED-HOLISTIC HEALTHCARE LLC (NPI 1700377876), doing business as Revered Holistic Healthcare Llc, is a healthcare organization registered as a family in Columbia, Maryland and active in the NPI registry since May 2018. The organization lists Adetutu Awodipe, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Revered-holistic Healthcare Llc 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 Revered-Holistic Healthcare LLC, 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 Revered-Holistic Healthcare LLC's NPI number?
The NPI number for Revered-Holistic Healthcare LLC is 1700377876. It was assigned to this organization in the NPPES registry on May 24, 2018. The provider is doing business as Revered Holistic Healthcare LLC.
Where is Revered-Holistic Healthcare LLC located?
Revered-Holistic Healthcare LLC is located at 9861 Broken Land Pkwy Ste 100, Columbia, MD 21046. The listed phone number is (443) 621-2203.
What is Revered-Holistic Healthcare LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Revered-Holistic Healthcare LLC enrolled in Medicare?
Yes. Revered-Holistic Healthcare LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Revered-Holistic Healthcare LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Revered-Holistic Healthcare LLC. 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 Revered-Holistic Healthcare LLC was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.
# Revered-Holistic Healthcare Llc · NPI 1700377876
Family organization in Columbia, Maryland. Organization record, active in the CMS NPPES registry since May 24, 2018.
## Identity
- **NPI:** 1700377876 (Entity type: Organization)
- **Enumerated:** May 24, 2018
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Also known as:** REVERED HOLISTIC HEALTHCARE LLC (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Adetutu Awodipe, OWNER
## Practice location
- **Address:** 9861 BROKEN LAND PKWY STE 100, Columbia, MD 21046-3031
- **Phone:** (443) 621-2203 · **Fax:** (410) 381-0216
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 11, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1700377876) · Data from the CMS NPPES public registry.