REVIVE FAMILY CARE & WELLNESS LLC – Family Nurse Practitioner, NPI 1447001003

REVIVE FAMILY CARE & WELLNESS LLC is a healthcare provider. based in Caddo mills, Texas. specializing in Family Nurse Practitioner. The NPI Number for REVIVE FAMILY CARE & WELLNESS LLC is 1447001003

Main info

Organization
Name
REVIVE FAMILY CARE & WELLNESS LLC
NPI
1447001003
Phone
(903) 751-5550
Address
3667 COUNTY ROAD 2134 STE C
Authorized Official
MRS. GUISELLE IVETTE BERRY OWNER NP
Enumeration Date
1 April 2024
Last Update Date
7 January 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:2State licenses:0Digital endpointsOther names

Provider Addresses for REVIVE FAMILY CARE & WELLNESS LLC

  • 3667 COUNTY ROAD 2134 STE C

    CADDO MILLS, TX 751356897

    Phone: (903) 751-5550

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-07-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20240701003768OClinic/Group PracticeTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 75135)

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Reviews

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Frequently asked questions

Does REVIVE FAMILY CARE & WELLNESS LLC have a public NPI I can cite?
Public records show REVIVE FAMILY CARE & WELLNESS LLC under NPI 1447001003.
Is REVIVE FAMILY CARE & WELLNESS LLC currently accepting referrals based on NPI status?
Registry metadata lists REVIVE FAMILY CARE & WELLNESS LLC as active.
How should patients interpret REVIVE FAMILY CARE & WELLNESS LLC's specialty?
The extract shows Family Nurse Practitioner for REVIVE FAMILY CARE & WELLNESS LLC. Clinical services aligned with this taxonomy classification.
Can patients visit REVIVE FAMILY CARE & WELLNESS LLC in Caddo Mills, Texas?
For routing, start with Caddo Mills, Texas for REVIVE FAMILY CARE & WELLNESS LLC, then verify phone and hours locally.
Why is information missing for REVIVE FAMILY CARE & WELLNESS LLC?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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