REVIVED WELLNESS LLC
NPI 1891653523
Family Medicine in Centerville, UT
About Revived Wellness Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
REVIVED WELLNESS LLC (NPI 1891653523) is a healthcare organization registered as a family medicine in Centerville, Utah and active in the NPI registry since January 2026. The organization lists Jonathan Barker, Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
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)
Revived Wellness 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 Revived Wellness 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 Revived Wellness LLC's NPI number?
The NPI number for Revived Wellness LLC is 1891653523. It was assigned to this organization in the NPPES registry on January 12, 2026.
Where is Revived Wellness LLC located?
Revived Wellness LLC is located at 776 E 800 S, Centerville, UT 84014. The listed phone number is (801) 424-9922.
What is Revived Wellness LLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Revived Wellness LLC enrolled in Medicare?
Yes. Revived Wellness LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Revived Wellness LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Revived Wellness 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 Revived Wellness LLC was last updated on January 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Revived Wellness Llc · NPI 1891653523
Family Medicine organization in Centerville, Utah. Organization record, active in the CMS NPPES registry since January 12, 2026.
## Identity
- **NPI:** 1891653523 (Entity type: Organization)
- **Enumerated:** January 12, 2026
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Jonathan Barker, MANAGER
## Practice location
- **Address:** 776 E 800 S, Centerville, UT 84014-2512
- **Phone:** (801) 424-9922
## 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:** January 12, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1891653523) · Data from the CMS NPPES public registry.