Organization Active NPI

Revision Wellness SC

  • Pediatrics Physician
  • Marshfield, WI
National Provider Identifier
1871459461
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
REVISION WELLNESS SC
Practice address
203 W Upham St
Marshfield, WI 54449-1460
Phone
(715) 204-9697
Fax
(715) 620-1355
NPI assigned
Dec 29, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2025

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

Authorized official

Name
Amy FalkNPI 1205179579
Title
MD
Phone
(715) 204-9697

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
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

203 W Upham St
Marshfield, WI 54449-1460

Mailing address

203 W Upham St
Marshfield, WI 54449-1460

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D2330154Revision Wellness, SC203 West Upham Street, Marshfield, WI 54449Certificate of waiverSep 10, 2027

National Provider Directory

National Provider Directory

Locations

203 W Upham St
Marshfield, WI 54449
Phone (715) 204-9697

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1766966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766966400000",
    "number": "1871459461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 W UPHAM ST",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544491460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 W UPHAM ST",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544491460",
            "telephone_number": "715-204-9697",
            "fax_number": "715-620-1355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVISION WELLNESS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-29",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A",
        "authorized_official_last_name": "FALK",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "715-204-9697"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.