Revive Ink Studio, LLC

Primary specialty

Other Specialist/TechnologistTaxonomy code 246Z00000X

Legal business name

REVIVE INK STUDIO, LLC

Practice address

12205 County Line Rd Ste F
Madison, AL 35758-7720

Phone

(256) 400-0771

NPI assigned

Sep 21, 2026

Last updated

Sep 21, 2026By 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

Ms. Erika Lynn John

Title

Owner

Phone

(904) 907-0143

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1789948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789948800000",
    "number": "1306758586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 WILSON HALL DR",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357578701",
            "telephone_number": "256-400-0771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12205 COUNTY LINE RD STE F",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357587720",
            "telephone_number": "256-400-0771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE INK STUDIO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-21",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A",
        "authorized_official_last_name": "JOHN",
        "authorized_official_first_name": "ERIKA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-907-0143",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.