Revive Wellness of Kennesaw LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

REVIVE WELLNESS OF KENNESAW LLC

Practice address

2819 Dallas St NW
Kennesaw, GA 30144-2705

Phone

(770) 401-6686

NPI assigned

May 20, 2026

Last updated

Jun 24, 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

Julia Everheart

Title

Office Manager

Phone

(470) 370-9280

Specialties & licenses 1

Addresses

Locations

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.

• Justin Kyle Willis, D.C.

  • Chiropractor
  • Kennesaw, GA
  • NPI 1639501588
  NPD

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

{
    "created_epoch": "1779235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782259200000",
    "number": "1033049390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2819 DALLAS ST NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301442705",
            "telephone_number": "770-212-1425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2819 DALLAS ST NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301442705",
            "telephone_number": "770-401-6686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE WELLNESS OF KENNESAW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-20",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A",
        "authorized_official_last_name": "EVERHEART",
        "authorized_official_first_name": "JULIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "470-370-9280"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reside Well, LLC (Assisting Hands Kennesaw)
• Resident Care Services, Inc. (RCS, Inc.)
• Christina Resolus, CCC-SLP
• Resolute Counseling and Consulting LLC
• Resurgens, LLC (Resurgens Orthopaedics)
• Jennifer G Rewis, CNM
• Holaya Danyabel Reyes
• Magaly Reyes
• Jonathan Alexander Reynolds
• Joseph C Reynolds II, P.A

• General Practice Physician in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• General Practice Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.