Revivo Medical PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

REVIVO MEDICAL PA

Practice address

9441 Lyndon B Johnson Fwy Ste 103B
Dallas, TX 75243-4545

Phone

(469) 466-2251

NPI assigned

Jun 23, 2025

Last updated

Jun 23, 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

Michael K Schrader, MDNPI 1053398404

Title

Owner

Phone

(469) 235-1263

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 2

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.

• Michael Keith Schrader, M.D.

  • Internal Medicine Physician
  • Plano, TX
  • NPI 1053398404
  Medicare reassignment NPD Authorized official
• Kerri Swiggart, P.A.

  • Medical Physician Assistant
  • Houston, TX
  • NPI 1568493344
  Medicare reassignment NPD

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

{
    "created_epoch": "1750636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750636800000",
    "number": "1528955358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9441 LYNDON B JOHNSON FWY STE 103B",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752434545",
            "telephone_number": "469-466-2251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9441 LYNDON B JOHNSON FWY STE 103B",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752434545",
            "telephone_number": "469-466-2251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVO MEDICAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-23",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A",
        "authorized_official_last_name": "SCHRADER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "469-235-1263",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Revive PCMS Highland Park PLLC
• Revive Therapeutic Center
• Revive to Thrive Wellness Center, PLLC
• Revive Whole Life Solutions LLC
• Revivify Revenue Cycle Consulting LLC
• Revolution Monitoring
• Revolution Monitoring Management, LLC
• Revolution Neuromonitoring, LLC
• Mollie Rew
• David Austin Rex, CRNA

• Internal Medicine Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.