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REVIVAL WELLNESS LLC
NPI 1790653533
Family Medicine - Adult Medicine in Morris, MN

Active since October 24, 2025
511 OREGON AVE PDT SUITE B3, MORRIS, MN 56267(320) 491-0594(320) 491-0594 Get Directions Write a Review

NPPES record last updated: October 24, 2025. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Revival Wellness Llc NPPES

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

REVIVAL WELLNESS LLC (NPI 1790653533) is a healthcare organization registered as an adult medicine in Morris, Minnesota and active in the NPI registry since October 2025. The organization lists Nathan Bryant Malek, Ceo, as its authorized official.

NPPES Registry Identity

NPI1790653533
Entity TypeOrganization
Primary Taxonomy207QA0505X
Legal Business NameREVIVAL WELLNESS LLC
Location Address511 OREGON AVE PDT SUITE B3Morris, MN 56267
Mailing Address511 Oregon AveMorris, MN 56267-3712 · (320) 491-0594 · Fax (320) 491-0594
Phone(320) 491-0594
Fax(320) 491-0594
Organization SubpartNo
Authorized OfficialNathan Bryant MalekCeo · (320) 491-0594
Enumeration DateOctober 24, 2025
NPPES CertifiedOctober 7, 2025
✔ NPI 1790653533 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Adult MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0505X
Definition
The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.
511 OREGON AVE PDT SUITE B3, Morris, MN 56267
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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

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 Revival Wellness LLC's NPI number?

The NPI number for Revival Wellness LLC is 1790653533. It was assigned to this organization in the NPPES registry on October 24, 2025.

Where is Revival Wellness LLC located?

Revival Wellness LLC is located at 511 Oregon Ave Pdt Suite B3, Morris, MN 56267. The listed phone number is (320) 491-0594.

What is Revival Wellness LLC's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.

When was this NPI record last updated?

The NPPES record for Revival Wellness LLC was last updated on October 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.