Revive Community Health

Primary specialty

Wound Care Registered NurseTaxonomy code 163WW0000X

Legal business name

REVIVE COMMUNITY HEALTH

Doing business as

Revive Community Health
Revive Community Health LLC

Practice address

4700 S McClintock Dr Ste 140
Tempe, AZ 85282-7375

Phone

(480) 851-6309

NPI assigned

Mar 15, 2021

Organization subpart

No

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

Authorized official

Name

Micah Phillips

Title

Coo

Phone

(602) 717-8599

Specialties & licenses 5

Addresses

Other names 2

• Revive Community Health Doing business as
• Revive Community Health LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ, TX2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 9

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.

• Kelly A Lapa, FNP-C

  • Family Nurse Practitioner
  • Tempe, AZ
  • NPI 1255856803

  Family Medicine

  Medicare reassignment NPD
• Michael A Lavor, MD

  • Surgery Physician
  • Tucson, AZ
  • NPI 1063440972
  Medicare reassignment NPD
• Emmanuel Marseille, CSA, MD, PA

  • Physician Assistant
  • Tempe, AZ
  • NPI 1851860316
  Medicare reassignment NPD
• Kristin Melendez, DNP

  • Family Nurse Practitioner
  • Tucson, AZ
  • NPI 1194496026
  Medicare reassignment NPD
• Aja Murphy, DO

  • Wound Care Registered Nurse
  • Tempe, AZ
  • NPI 1467604942

  TX

  Medicare reassignment NPD
• D'Andra Humphrey, FNP

  • Family Nurse Practitioner
  • Shreveport, LA
  • NPI 1154797223

  TX

  Medicare reassignment NPD
• Colin Greenhill, PA

  • Physician Assistant
  • Tempe, AZ
  • NPI 1386272904
  Medicare reassignment
• Donia Ibrahim, PA-C

  • Physician Assistant
  • Tempe, AZ
  • NPI 1275159840
  Medicare reassignment
• Rhodelie Louis

  • Physician Assistant
  • Tucson, AZ
  • NPI 1134806763

  Family Medicine

  NPD

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

{
    "created_epoch": "1615766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787788800000",
    "number": "1255916987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 S MCCLINTOCK DR STE 140",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827375",
            "telephone_number": "480-851-6309",
            "fax_number": "573-240-9791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 S MCCLINTOCK DR STE 140",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827375",
            "telephone_number": "480-851-6309"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7140 E Rosewood St Ste 110",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857101320",
            "country_code": "US",
            "telephone_number": "480-851-6309",
            "fax_number": "573-240-9791",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REVIVE COMMUNITY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-15",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "MICAH",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "602-717-8599"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Wound Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revive Community Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Revive Community Health LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Laurel Retay, DO
• Revamp Wellness Center
• Revive Hive LLC
• Revive Physical Therapy and Wellness, PLLC
• Jascelyn Ann Revland, M.A.
• Reyes Family Medicine, PLC
• James A Reyes

• Wound Care Registered Nurse in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Wound Care Registered Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.