Revive Wellness Clinic of Starkville, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

REVIVE WELLNESS CLINIC OF STARKVILLE, LLC

Practice address

100 Russell St Ste 19
Starkville, MS 39759-3398

Phone

(662) 801-5795

NPI assigned

Oct 1, 2026

Last updated

Oct 1, 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

Sarah Clark

Title

Manager

Phone

(662) 801-5795

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

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

{
    "created_epoch": "1790812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790812800000",
    "number": "1558275008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RUSSELL ST STE 19",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397593398",
            "telephone_number": "662-801-5795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RUSSELL ST STE 19",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397593398",
            "telephone_number": "662-801-5795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE WELLNESS CLINIC OF STARKVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-01",
        "last_updated": "2026-10-01",
        "certification_date": "2026-10-01",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "662-801-5795"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Starkville, MS
• Providers in Starkville, MS by specialty
• Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.

Verify at the official NPI Registry.