NPIMap

Organization Active NPI

Revive Clinic LLC

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Columbia, MD
National Provider Identifier
1003797176
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X
Legal business name
REVIVE CLINIC LLC
Practice address
10440 Little Patuxent Pkwy Ste 300
Columbia, MD 21044-3648
Phone
(240) 744-0540
Fax
(866) 538-1415
NPI assigned
Sep 8, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Denisha Cuffee, NPNPI 1932754264
Title
Owner/Provider
Phone
(240) 744-0540

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Clinical Nurse SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 364SP0808X Primary

Addresses

Primary practice location

10440 Little Patuxent Pkwy Ste 300
Columbia, MD 21044-3648

Mailing address

10440 Little Patuxent Pkwy Ste 300
Columbia, MD 21044-3648
Phone (240) 744-0540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251205001319 MD Part B Supplier - Clinic/Group Practice 7517450794 Receives reassigned benefits from 1 practitioner
Practice locations: Columbia, MD

National Provider Directory

National Provider Directory
Tax ID family
Revive Clinic LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1757289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778544000000",
    "number": "1003797176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10440 LITTLE PATUXENT PKWY STE 300",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443648",
            "telephone_number": "240-744-0540",
            "fax_number": "866-538-1415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10440 LITTLE PATUXENT PKWY STE 300",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443648",
            "telephone_number": "240-744-0540",
            "fax_number": "866-538-1415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-08",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A",
        "authorized_official_last_name": "CUFFEE",
        "authorized_official_first_name": "DENISHA",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "240-744-0540",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.