Revive Medical & Aesthetic Clinic

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

REVIVE MEDICAL & AESTHETIC CLINIC

Practice address

7313 Hanover Pkwy Ste a
Greenbelt, MD 20770-3667

Phone

(301) 412-5522

Fax

(301) 498-7436

NPI assigned

Nov 29, 2022

Organization subpart

No

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

Authorized official

Name

Florence Ukenye, FNPNPI 1255722187

Title

Clinical Director

Phone

(301) 412-5522

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 3

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Practitioners 2

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

• Florence Chinwe Ukenye, CRNP (NURSE PRACTITI

  • Nurse Practitioner
  • Clinton, MD
  • NPI 1255722187

  DC

  Medicare reassignment Care Compare group NPD Authorized official
• Felicitas Onyekweli, NP

  • Family Nurse Practitioner
  • Greenbelt, MD
  • NPI 1053020644

  DC

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1669680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669680000000",
    "number": "1104536358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7313 HANOVER PKWY STE A",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207703667",
            "telephone_number": "301-412-5522",
            "fax_number": "301-498-7436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7313 HANOVER PKWY STE A",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207703667",
            "telephone_number": "301-412-5522",
            "fax_number": "301-498-7436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE MEDICAL & AESTHETIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-29",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A",
        "authorized_official_last_name": "UKENYE",
        "authorized_official_first_name": "FLORENCE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "301-412-5522",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "NA",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@revivemedaesthetic.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Messaging",
            "address_1": "7313 Hanover Pkwy Ste A",
            "city": "Greenbelt",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207703667",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "NA",
            "affiliation": "N",
            "address_1": "7313 Hanover Pkwy Ste A",
            "city": "Greenbelt",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207703667",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "NA",
            "affiliation": "N",
            "endpointDescription": "NA",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "NA",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "NA",
            "address_1": "7313 Hanover Pkwy Ste A",
            "city": "Greenbelt",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207703667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Renaissance Foot & Ankle Center, PC
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• Renuka Gupta MD PC
• Maria L Restrepo Calis, MD
• Gustavo Restrepo, MD
• Bonita Reyes
• Rhaba Health LLC
• Richard S Cohen DPM PA
• Richard S Cohen DPM PA
• Richard S Cohen DPM PA

• Primary Care Clinic/Center in Greenbelt, MD
• Providers in Greenbelt, MD by specialty
• Primary Care Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; 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.