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REVITALIZE PSYCHIATRY, PLLC
NPI 1720792799
Clinic/Center - Mental Health (Including Community Mental Health Center) in Charlotte, NC

Active since January 13, 2023
11220 ELM LN STE 203-9, CHARLOTTE, NC 28277(704) 459-2181(704) 533-9516 Get Directions Write a Review

NPPES record last updated: April 2, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 2, 2023, Jan 13, 2023 (2 updates tracked since 2023).

About Revitalize Psychiatry, Pllc NPPES

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

REVITALIZE PSYCHIATRY, PLLC (NPI 1720792799) is a healthcare organization registered as a mental health (including community mental health center) in Charlotte, North Carolina and active in the NPI registry since January 2023. The organization lists Casey Watson, Owner, as its authorized official.

NPPES Registry Identity

NPI1720792799
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameREVITALIZE PSYCHIATRY, PLLC
Location Address11220 ELM LN STE 203-9Charlotte, NC 28277-0715
Mailing Address8022 Providence Rd Ste 500-229Charlotte, NC 28277-9719 · (704) 459-2181 · Fax (704) 533-9516
Phone(704) 459-2181
Fax(704) 533-9516
Organization SubpartNo
Authorized OfficialCasey WatsonOwner · (704) 459-2181
Enumeration DateJanuary 13, 2023
Last NPPES UpdateApril 2, 20232 updates tracked since enumeration
NPPES CertifiedApril 2, 2023
✔ NPI 1720792799 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
11220 ELM LN STE 203-9, Charlotte, NC 28277
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.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)

Revitalize Psychiatry, Pllc 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 Revitalize Psychiatry, PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Casey Watson, FNP, PMHNP
Nurse Practitioner
NPI 1164890281
11220 ELM LN STE 203
Charlotte, NC 28277
(704) 459-2181
✔ PECOS✔ 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 Revitalize Psychiatry, PLLC's NPI number?

The NPI number for Revitalize Psychiatry, PLLC is 1720792799. It was assigned to this organization in the NPPES registry on January 13, 2023.

Where is Revitalize Psychiatry, PLLC located?

Revitalize Psychiatry, PLLC is located at 11220 Elm Ln Ste 203-9, Charlotte, NC 28277. The listed phone number is (704) 459-2181.

What is Revitalize Psychiatry, PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

Is Revitalize Psychiatry, PLLC enrolled in Medicare?

Yes. Revitalize Psychiatry, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Revitalize Psychiatry, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Revitalize Psychiatry, PLLC. 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 Revitalize Psychiatry, PLLC accept?

Health plans from Blue Cross and Blue Shield of NC list Revitalize Psychiatry, PLLC 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 Revitalize Psychiatry, PLLC was last updated on April 2, 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.