Revival Acupuncture Clinic LLC

Primary specialty

AcupuncturistTaxonomy code 171100000X

Legal business name

REVIVAL ACUPUNCTURE CLINIC LLC

Practice address

9685 Main St Ste C
Fairfax, VA 22031-3752

Phone

(301) 747-5336

NPI assigned

Dec 14, 2024

Last updated

Jul 5, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rhea Kim, L.ACNPI 1821829219

Title

Acupuncturist

Phone

(571) 301-9661

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rhea Kim, LAC

  • Acupuncturist
  • Fairfax, VA
  • NPI 1821829219
  NPD Authorized official

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

{
    "created_epoch": "1734134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783209600000",
    "number": "1023825999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4277 SLEEPY LAKE DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332864",
            "telephone_number": "301-747-5336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9685 MAIN ST STE C",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220313752",
            "telephone_number": "301-747-5336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVAL ACUPUNCTURE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-14",
        "last_updated": "2026-07-05",
        "certification_date": "2026-07-05",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "RHEA",
        "authorized_official_title_or_position": "ACUPUNCTURIST",
        "authorized_official_telephone_number": "571-301-9661",
        "authorized_official_credential": "L.AC"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.