Revive Health And Injury Center, Llc is a medicare enrolled "Nurse Practitioner - Acute Care" provider in Springfield, Ohio. Their current practice location is
333 N Limestone St Ste 104, Springfield, Ohio. You can reach out to their office (for appointments etc.) via phone at
(937) 319-4343.
Revive Health And Injury Center, Llc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Revive Health And Injury Center, Llc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1720554959.
Healthcare Provider's Profile
| Full Name | Revive Health And Injury Center, Llc |
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| Type | Facility |
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| Speciality | Nurse Practitioner - Acute Care |
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| Location | 333 N Limestone St Ste 104, Springfield, Ohio |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1720554959
- Provider Enumeration Date: 10/15/2018
- Last Update Date: 12/14/2022
Medicare PECOS Information:
- PECOS PAC ID: 0648523035
- Enrollment ID: O20181101001599
Medical Identifiers
Medical identifiers for Revive Health And Injury Center, Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1720554959 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 111N00000X | Chiropractor | (* (Not Available)) | Secondary |
| 363LA2100X | Nurse Practitioner - Acute Care | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Revive Health And Injury Center, Llc acts as a billing entity for following providers:
| Provider Name | Barry S Pedicord |
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| Provider Type | Practitioner - Chiropractic |
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| Provider Identifiers | NPI Number: 1356485858
PECOS PAC ID: 5294982435
Enrollment ID: I20120823000484 |
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| Provider Name | Jason Anthony Malucci |
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| Provider Type | Practitioner - Chiropractic |
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| Provider Identifiers | NPI Number: 1578779062
PECOS PAC ID: 5496717118
Enrollment ID: I20181101001684 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Revive Health And Injury Center, Llc is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Revive Health And Injury Center, Llc
333 N Limestone St Ste 104,
Springfield, OH 45503-4250
Ph: (937) 319-4343 | Revive Health And Injury Center, Llc
333 N Limestone St Ste 104,
Springfield, OH 45503-4250
Ph: (937) 319-4343 |
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