Revive Family Care & Wellness LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

REVIVE FAMILY CARE & WELLNESS LLC

Practice address

3667 County Road 2134 Ste C
Caddo Mills, TX 75135-6897

Phone

(903) 751-5550

Fax

(833) 973-3638

NPI assigned

Apr 1, 2024

Last updated

Jan 7, 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

Mrs. Guiselle Ivette Berry, NPNPI 1184362964

Title

Owner

Phone

(214) 709-2522

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 6

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.

• Guiselle Berry, FNP-C

  • Family Nurse Practitioner
  • Caddo Mills, TX
  • NPI 1184362964
  Medicare reassignment Care Compare group NPD Authorized official
• Monica Booker, FNP

  • Nurse Practitioner
  • Caddo Mills, TX
  • NPI 1790581064
  Medicare reassignment Care Compare group NPD
• Jennifer Slencak, MSN, APRN, FNP-C

  • Nurse Practitioner
  • Rockwall, TX
  • NPI 1326535311
  Medicare reassignment NPD
• Carrie Lin Hernandez, APRN-C

  • Family Nurse Practitioner
  • Greenville, TX
  • NPI 1295338978
  NPD
• Shannon Kelly Kennedy, FNP-C

  • Family Nurse Practitioner
  • Caddo Mills, TX
  • NPI 1457080228
  NPD
• Courtney Patrick, NP

  • Family Nurse Practitioner
  • Caddo Mills, TX
  • NPI 1245152016

  Single Specialty

  NPD

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

{
    "created_epoch": "1711929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736208000000",
    "number": "1447001003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3667 COUNTY ROAD 2134 STE C",
            "city": "CADDO MILLS",
            "state": "TX",
            "postal_code": "751356897",
            "telephone_number": "903-751-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3667 COUNTY ROAD 2134 STE C",
            "city": "CADDO MILLS",
            "state": "TX",
            "postal_code": "751356897",
            "telephone_number": "903-751-5550",
            "fax_number": "833-973-3638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE FAMILY CARE & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-01",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "GUISELLE",
        "authorized_official_middle_name": "IVETTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-709-2522",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Mathew
• Isabella McElroy, RDN
• Shawna Moreland
• Sharon L Paine, NP
• Courtney Patrick, NP
• Lindsey Nicole Roberts, M.S. CCC-SLP
• Andria Scully, LCSW
• Valerie Smith, RBT
• Sparta Wellness Clinic PLLC
• Gina M Sullivan, CMA CPC

• Family Nurse Practitioner in Caddo Mills, TX
• Providers in Caddo Mills, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.