Clinica Revive Salud PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

CLINICA REVIVE SALUD PLLC

Practice address

6524 W Indian School Rd Ste a
Phoenix, AZ 85033-3329

Phone

(602) 892-0799

Fax

(602) 892-0828

NPI assigned

Sep 12, 2022

Organization subpart

No

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

Authorized official

Name

Nubia C Lomeli, DNP, FNP-CNPI 1619328374

Title

Medical Director

Phone

(602) 892-0799

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

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

CLIA laboratory certificates

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JJIBDD

Practitioners 2

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

• Nubia Lomeli, DNP, FNP-C

  • Family Nurse Practitioner
  • Phoenix, AZ
  • NPI 1619328374
  Medicare reassignment Care Compare group NPD Authorized official
• Paula M Hernandez, DNP, FNP-C

  • Family Nurse Practitioner
  • Phoenix, AZ
  • NPI 1316559289
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711929600000",
    "number": "1750003323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6524 W INDIAN SCHOOL RD STE A",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850333329",
            "telephone_number": "602-892-0799",
            "fax_number": "602-892-0828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6524 W INDIAN SCHOOL RD STE A",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850333329",
            "telephone_number": "602-892-0799",
            "fax_number": "602-892-0828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA REVIVE SALUD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-12",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A",
        "authorized_official_last_name": "LOMELI",
        "authorized_official_first_name": "NUBIA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "602-892-0799",
        "authorized_official_credential": "DNP, FNP-C"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Primary Care Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.