Reviva Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

REVIVA CLINIC

Practice address

4216 Evergeen Lane
Ste 125
Annandale, VA 22003-3456

Phone

(240) 284-9501

Fax

(703) 662-6165

NPI assigned

Sep 8, 2025

Organization subpart

No

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

Authorized official

Name

Jiho Choi, MD

Title

Owner

Phone

(301) 893-4568

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1757289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773878400000",
    "number": "1669352738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5185 MACARTHUR BLVD NW # 713",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200163341",
            "telephone_number": "301-893-4568",
            "fax_number": "240-427-9710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4216 EVERGEEN LANE",
            "address_2": "STE 125",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220033456",
            "telephone_number": "240-284-9501",
            "fax_number": "703-662-6165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVA CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-08",
        "last_updated": "2026-03-19",
        "certification_date": "2026-03-19",
        "status": "A",
        "authorized_official_last_name": "CHOI",
        "authorized_official_first_name": "JIHO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-893-4568",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Annandale, VA
• Providers in Annandale, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2026; 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.