Organization Active NPI

Dream Revival Psychiatry

  • Psychiatric/Mental Health Nurse Practitioner
  • McKinney, TX
National Provider Identifier
1679377618
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
DREAM REVIVAL PSYCHIATRY
Practice address
1400 N Coit Rd Ste 202
McKinney, TX 75071-6656
Phone
(469) 949-4941
NPI assigned
Apr 1, 2025
Last updated
Oct 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Authorized official

Name
Jona OdimNPI 1982422952
Title
Pmhnp
Phone
(469) 335-6133

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

1400 N Coit Rd Ste 202
McKinney, TX 75071-6656

Mailing address

1400 N Coit Rd Ste 202
McKinney, TX 75071-6656
Phone (469) 949-4941

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20250625003409 TX Part B Supplier - Clinic/Group Practice 0941712855 Receives reassigned benefits from 3 practitioners
Practice locations: Richardson, TX
O20251110003666 CO Part B Supplier - Clinic/Group Practice 0941712855 Receives reassigned benefits from 1 practitioner
Practice locations: Aurora, CO

National Provider Directory

National Provider Directory

Locations

1400 N Coit Rd
Ste 202
McKinney, TX 75071
Phone (469) 949-4941

1201 S Sherman St
Ste 213
Richardson, TX 75081
Phone (214) 935-8303

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1743465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761091200000",
    "number": "1679377618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 N COIT RD STE 202",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750716656",
            "telephone_number": "469-949-4941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N COIT RD STE 202",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750716656",
            "telephone_number": "469-949-4941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DREAM REVIVAL PSYCHIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-01",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A",
        "authorized_official_last_name": "ODIM",
        "authorized_official_first_name": "JONA",
        "authorized_official_title_or_position": "PMHNP",
        "authorized_official_telephone_number": "469-335-6133"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McKinney, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.