Organization Active NPI

Revitalized Health PLLC

Doing business as Revitalized Lifestyle Medicine Consulting

  • Internal Medicine Physician
  • Covington, KY
National Provider Identifier
1225913916
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
REVITALIZED HEALTH PLLC
Doing business as
Revitalized Lifestyle Medicine Consulting
Practice address
516 Earle Ave
Covington, KY 41015-1611
Phone
(740) 202-0995
NPI assigned
Aug 11, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Authorized official

Name
Dr. Kalyn Jolivette, MDNPI 1447693239
Title
Owner and Physician
Phone
(740) 202-0995

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

516 Earle Ave
Covington, KY 41015-1611

Mailing address

516 Earle Ave
Covington, KY 41015-1611
Phone (740) 202-0995

Other names 1

  • Revitalized Lifestyle Medicine Consulting Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1754870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754870400000",
    "number": "1225913916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 EARLE AVE",
            "city": "COVINGTON",
            "state": "KY",
            "postal_code": "410151611",
            "telephone_number": "740-202-0995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 EARLE AVE",
            "city": "COVINGTON",
            "state": "KY",
            "postal_code": "410151611",
            "telephone_number": "740-202-0995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVITALIZED HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-11",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A",
        "authorized_official_last_name": "JOLIVETTE",
        "authorized_official_first_name": "KALYN",
        "authorized_official_title_or_position": "OWNER AND PHYSICIAN",
        "authorized_official_telephone_number": "740-202-0995",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revitalized Lifestyle Medicine Consulting",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Covington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.