Revival Hyperbarics

Primary specialty

Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X

Legal business name

REVIVAL HYPERBARICS

Practice address

11649 S 4000 W Ste 110
South Jordan, UT 84009-6039

Phone

(208) 251-7799

NPI assigned

Apr 8, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Wren Evan Murray

Title

Ceo/Owner

Phone

(208) 251-7799

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 1

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

• Bengt Christian Lock, NP-C

  • Nurse Practitioner
  • Bluffdale, UT
  • NPI 1497417919
  Medicare reassignment

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

{
    "created_epoch": "1712534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1013760586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11649 S 4000 W STE 110",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840096039",
            "telephone_number": "208-251-7799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11649 S 4000 W STE 110",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840096039",
            "telephone_number": "208-251-7799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVAL HYPERBARICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-08",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "MURRAY",
        "authorized_official_first_name": "WREN",
        "authorized_official_middle_name": "EVAN",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "208-251-7799",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2083P0011X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tania M Reitz, DPT
• Relational Growth Center
• Renaissance Rehabilitation of South Jordan
• Renewed Connections Therapy
• Leonard Rentfro, CMHC
• Revive Health and Chiropractic Inc
• Revivology
• Mackenzie Lauren Rich, RD
• Richard Eason DPM PC
• John L Richards, MD

• Undersea and Hyperbaric Medicine (Preventive Medicine) Physician in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Undersea and Hyperbaric Medicine (Preventive Medicine) Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.