REVIVE LIFE LLC
NPI 1740081223
Clinic/Center - Multi-Specialty in Gaithersburg, MD

Q: What is Revive Life LLC's NPI number?

The NPI number for Revive Life LLC is 1740081223. It was assigned to this organization in the NPPES registry on March 21, 2025.

Q: What is Revive Life LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Q: When was this NPI record last updated?

The NPPES record for Revive Life LLC was last updated on March 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since March 21, 2025

316 E DIAMOND AVE, GAITHERSBURG, MD 20877(206) 898-5432 Get Directions Write a Review

NPPES record last updated: March 25, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 25, 2026, Mar 2, 2026, Feb 5, 2026 and 1 more (4 updates tracked since 2025).

On this page

About Revive Life Llc NPPES

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

REVIVE LIFE LLC (NPI 1740081223) is a healthcare organization registered as a multi-specialty in Gaithersburg, Maryland and active in the NPI registry since March 2025. The organization lists Radhika Nataraj, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1740081223

Entity TypeOrganization

Primary Taxonomy261QM1300X

Legal Business NameREVIVE LIFE LLC

Location Address316 E DIAMOND AVEGaithersburg, MD 20877-3070

Mailing Address316 E Diamond AveGaithersburg, MD 20877-3070 · (301) 252-1866 · Fax (301) 345-3516

Phone(206) 898-5432

Organization SubpartNo

Authorized OfficialRadhika NatarajAuthorized Official · (301) 252-1866

Enumeration DateMarch 21, 2025

Last NPPES UpdateMarch 25, 20264 updates tracked since enumeration

NPPES CertifiedMarch 25, 2026

✔ NPI 1740081223 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities

Taxonomy Code261QM1300X

Also ListedPsychologistTaxonomy 103T00000X

Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X

Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X

316 E DIAMOND AVE, Gaithersburg, MD 20877

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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

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 Life Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 4 clinicians reassign Medicare billing to Revive Life LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Tashaniyi Byrd, CRNP-PMH

Nurse Practitioner

NPI 1629890678

316 E DIAMOND AVE
Gaithersburg, MD 20877

(301) 345-1102

✔ PECOS✔ Accepts MedicareSame address

Coleia Simpson, LCSW-C

Clinical Social Worker

NPI 1225793052

12027 AMBER RIDGE CIR
Germantown, MD 20876

(202) 780-9689

✔ PECOS4.9 mi

Kamal Bhatia, M.D.

Psychiatry

NPI 1255568010

10709 BIRMINGHAM WAY
Woodstock, MD 21163

(301) 288-1028

✔ PECOS20 mi

Krupa Nataraj, M.D.

Psychiatry

NPI 1720511272

178 MAPLE CT
Johnson City, TN 37615

(301) 836-1346

✔ PECOS✔ Accepts Medicare345 mi

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 Life LLC's NPI number?

The NPI number for Revive Life LLC is 1740081223. It was assigned to this organization in the NPPES registry on March 21, 2025.

Where is Revive Life LLC located?

Revive Life LLC is located at 316 E Diamond Ave, Gaithersburg, MD 20877. The listed phone number is (206) 898-5432.

What is Revive Life LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Is Revive Life LLC enrolled in Medicare?

Yes. Revive Life LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Revive Life LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Revive Life LLC, in Clinical Social Worker, Nurse Practitioner and Psychiatry. 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. Of these, 1 practice at this address and 2 within 10 miles. 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 Life LLC was last updated on March 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.