Active NPI
Revive Hydration PLLC
- Psychiatric/Mental Health Nurse Practitioner
- Red Bud, IL
National Provider Identifier
1831003250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- Legal business name
- REVIVE HYDRATION PLLC
- Practice address
- 505 S Main St
Red Bud, IL 62278-1212 - Phone
- (618) 408-1248
- NPI assigned
- Oct 1, 2026
- Last updated
- Oct 1, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jennifer Knott, APRN, PMHNP-BC
- Title
- Owner / Member
- Phone
- (618) 615-8898
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | NU | Primary |
Addresses
Primary practice location
505 S Main St
Red Bud, IL 62278-1212
Mailing address
4740 Kane Hill Rd
Ellis Grove, IL 62241-1728
Phone (618) 408-1248
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Psychiatric/Mental Health Nurse Practitioner
- Red Bud, IL
- NPI 1780538538
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790812800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1790812800000",
"number": "1831003250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4740 KANE HILL RD",
"city": "ELLIS GROVE",
"state": "IL",
"postal_code": "622411728",
"telephone_number": "618-408-1248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 S MAIN ST",
"city": "RED BUD",
"state": "IL",
"postal_code": "622781212",
"telephone_number": "618-408-1248"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "REVIVE HYDRATION PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-10-01",
"last_updated": "2026-10-01",
"certification_date": "2026-10-01",
"status": "A",
"authorized_official_last_name": "KNOTT",
"authorized_official_first_name": "JENNIFER",
"authorized_official_title_or_position": "OWNER / MEMBER",
"authorized_official_telephone_number": "618-615-8898",
"authorized_official_credential": "APRN, PMHNP-BC"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Red Bud, IL
- Red Bud Illinois Hospital Company, LLC (Red Bud Regional Hospital)
- Red Bud Illinois Hospital Company, LLC (Older Adult Health Center)
- Red Bud Physician Group LLC
- Peggy Ann Rehmer, RPH
- Shelley Dawn Reichling, FNP-BC
- Lisa Riechmann
- Amy Lynn Rohlfing, MD
- Kara Kimberly Roth, APN-DNP
- Pichet Santilukka, MD
- Kelly Schenk, LCPC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.