Revitalize Health

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

REVITALIZE HEALTH

Practice address

250 Northwest Blvd Ste 200
Coeur D Alene, ID 83814-2973

Phone

(208) 763-8920

Fax

(208) 203-0947

NPI assigned

Jul 29, 2026

Organization subpart

No

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

Authorized official

Name

Heather King, FNPNPI 1164895371

Title

Ceo

Phone

(208) 763-8920

Specialties & licenses 1

Addresses

Tax ID family

Revitalize Health2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Revitalize Health

  • Family Nurse Practitioner
  • Coeur D Alene, ID
  • NPI 1467323220
  NPD tax ID

Locations

Practitioners 1

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

• Heather Louise King, NP-C

  • Family Nurse Practitioner
  • Coeur D Alene, ID
  • NPI 1164895371
  NPD (past) Authorized official

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

{
    "created_epoch": "1785283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785283200000",
    "number": "1821910803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4204 N MOCCASIN RD",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838158826",
            "telephone_number": "208-763-8920",
            "fax_number": "208-763-8920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 NORTHWEST BLVD STE 200",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142973",
            "telephone_number": "208-763-8920",
            "fax_number": "208-203-0947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVITALIZE HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-29",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-763-8920",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Responders First, LLC
• Restart Counseling PLLC
• Restoration Woundcare Medical Group, P.a.
• Restored Paths
• Revitalize Health
• Kelly Rey
• Veronica Guadalupe Reyes, LMT
• Jordyn Reynolds
• Connor Rezzonico, PMHNP
• Kelly Rhoads, LCSW

• Nurse Practitioner in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.