Revitalize Health

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

REVITALIZE HEALTH

Practice address

913 W Canfield Ave
Coeur D Alene, ID 83815-9764

Phone

(208) 763-8920

Fax

(208) 203-0947

NPI assigned

Sep 15, 2025

Organization subpart

No

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

Authorized official

Name

Ms. Heather King, NPNPI 1164895371

Title

Ceo

Phone

(208) 763-8920

Specialties & licenses 1

Addresses

Tax ID family

Revitalize Health2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Revitalize Health

  • Nurse Practitioner
  • Coeur D Alene, ID
  • NPI 1821910803
  NPD tax ID

Practitioners 1

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

• Heather Louise King, NP-C

  • Family Nurse Practitioner
  • Coeur D Alene, ID
  • NPI 1164895371
  NPD Authorized official

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

{
    "created_epoch": "1757894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757894400000",
    "number": "1467323220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 W CANFIELD AVE",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838159764",
            "telephone_number": "208-763-8920",
            "fax_number": "208-203-0947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 W CANFIELD AVE",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838159764",
            "telephone_number": "208-763-8920",
            "fax_number": "208-203-0947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVITALIZE HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-15",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-763-8920",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Resonant Path Counseling LLC
• Responders First, LLC
• Restart Counseling PLLC
• Restoration Woundcare Medical Group, P.a.
• Restored Paths
• Revitalize Health
• Kelly Rey
• Veronica Guadalupe Reyes, LMT
• Jordyn Reynolds
• Connor Rezzonico, PMHNP

• Family Nurse Practitioner in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• Family Nurse Practitioner in Idaho

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