Redefyne- Skin & Body Revival

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

REDEFYNE- SKIN & BODY REVIVAL

Practice address

875 E Nine Mile Rd Ste 6
Pensacola, FL 32514-1708

Phone

(850) 542-7413

NPI assigned

Feb 14, 2025

Organization subpart

No

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

Authorized official

Name

Susan Pham, NPNPI 1407418296

Title

Owner

Phone

(850) 207-4063

Specialties & licenses 1

Addresses

Other names 1

• Redefyne- Skin & Body Revival Doing business as

Locations

Practitioners 1

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

• Susan Pham, NP

  • Family Nurse Practitioner
  • Pensacola, FL
  • NPI 1407418296
  NPD Authorized official

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

{
    "created_epoch": "1739491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739491200000",
    "number": "1598560575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 E NINE MILE RD STE 6",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325141708",
            "telephone_number": "850-542-7413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 E NINE MILE RD STE 6",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325141708",
            "telephone_number": "850-542-7413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDEFYNE- SKIN & BODY REVIVAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-14",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-207-4063",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Redefyne- Skin & Body Revival",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary Kathryn Reber, APRN
• Madeleine Paige Record
• Linda R Reddoch, CARDIO/RESP TECH
• Redeemed Mental Health and Recovery, PLLC
• Redefine Your Story, LLC
• Guinevere Jane Redick, M.D.
• Tracy Lea Redmond, NP
• Johnna Redwing Pearce, PTA
• William George Reed-Harnish, APRN
• Amy Jean Reed, M.D.

• Clinic/Center in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.