Revivify Wound Care and Soft Tissue Specialist

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

REVIVIFY WOUND CARE AND SOFT TISSUE SPECIALIST

Practice address

4533 Merkel Bluff St
Las Vegas, NV 89147-5128

Phone

(702) 886-2269

NPI assigned

Jun 20, 2025

Organization subpart

No

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

Authorized official

Name

Juan Gutierrez

Title

Owner

Phone

(702) 886-2269

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1750377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752105600000",
    "number": "1134016397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4533 MERKEL BLUFF ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891475128",
            "telephone_number": "702-886-2269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4533 MERKEL BLUFF ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891475128",
            "telephone_number": "702-886-2269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVIFY WOUND CARE AND SOFT TISSUE SPECIALIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-20",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A",
        "authorized_official_last_name": "GUTIERREZ",
        "authorized_official_first_name": "JUAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-886-2269"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Revive Crisis Clinic LLC
• Revive Injury & Wellness
• Revive Medical Center LLC
• Revive Therapy Health and Wellness Services LLC
• Revived Minds LLC
• Revivify Wound Care and Soft Tissue Specialty
• Misael Andrey Revolorio
• Revolution Health Center
• Jason Revuelto
• Rewire Behavioral Health

• Family Nurse Practitioner in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Family Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; 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.