Revive Healthcare Clinic LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

REVIVE HEALTHCARE CLINIC LLC

Practice address

1221 West Airport Fwy Ste# 209 Unit B
Irving, TX 75062

Phone

(214) 777-2703

Fax

(817) 865-1530

NPI assigned

Nov 25, 2024

Last updated

Mar 18, 2025By 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

Chekwube Martha OkoliNPI 1154028611

Title

Owner

Phone

(469) 567-9974

Specialties & licenses 1

Addresses

Other names 1

• Revive Healthcare Clinic LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 3

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.

• Chekwube Martha Okoli, APRN

  • Family Nurse Practitioner
  • Heartland, TX
  • NPI 1154028611
  Medicare reassignment NPD Authorized official
• Assah Asongtia, APRN-CNP/RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Fort Worth, TX
  • NPI 1144703216
  Medicare reassignment NPD
• Naureen Salim

  • Family Nurse Practitioner
  • Lewisville, TX
  • NPI 1881281905
  Medicare reassignment NPD

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

{
    "created_epoch": "1732492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742256000000",
    "number": "1174349104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 WEST AIRPORT FWY STE# 209 UNIT B",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "75062",
            "telephone_number": "214-777-2703",
            "fax_number": "817-865-1530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 WEST AIRPORT FWY STE# 209 UNIT B",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "75062",
            "telephone_number": "214-777-2703",
            "fax_number": "817-865-1530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE HEALTHCARE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-25",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A",
        "authorized_official_last_name": "OKOLI",
        "authorized_official_first_name": "CHEKWUBE",
        "authorized_official_middle_name": "MARTHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "469-567-9974"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revive Healthcare Clinic LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Revive Healthcare Clinic LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Rosemarie Resendez, D.P.M.
• Carla Resendiz, HIS
• Jame Elaine Restau, RN, MSN, ACNS-BC
• Restore Foot and Ankle PC
• Revive Dental, PA
• Revolution Monitoring, LLC
• Revolution Neuromonitoring, LLC
• Merli Mabel Reyes, PHARMACY TECHNICIAN
• Kelly Reyna
• Kimberly Reynolds, MS, CCC-SLP

• Primary Care Nurse Practitioner in Irving, TX
• Providers in Irving, TX by specialty
• Primary Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; 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.