Advanced Health Revision PLLC

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

Legal business name

ADVANCED HEALTH REVISION PLLC

Practice address

4201 Interway PL
Arlington, TX 76018-5668

Phone

(972) 978-2317

Fax

(800) 782-4295

NPI assigned

Jun 12, 2023

Organization subpart

No

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

Authorized official

Name

Kimberly R Neely, NPNPI 1841239738

Title

Owner / Nurse Practitioner

Phone

(972) 978-2317

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

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

• Kimberly R Neely, GNP

  • Gerontology Nurse Practitioner
  • Arlington, TX
  • NPI 1841239738
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1686528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776211200000",
    "number": "1235813114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "661 E MAIN ST STE 200",
            "address_2": "BOX 118",
            "city": "MIDLOTHIAN",
            "state": "TX",
            "postal_code": "760653365",
            "telephone_number": "972-903-4343",
            "fax_number": "800-782-4295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 INTERWAY PL",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760185668",
            "telephone_number": "972-978-2317",
            "fax_number": "800-782-4295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED HEALTH REVISION PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-12",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A",
        "authorized_official_last_name": "NEELY",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER / NURSE PRACTITIONER",
        "authorized_official_telephone_number": "972-978-2317",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gerontology Nurse Practitioner in Arlington, TX
• Providers in Arlington, TX by specialty
• Gerontology Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2026; 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.