Revived Wellness LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

REVIVED WELLNESS LLC

Practice address

776 E 800 S
Centerville, UT 84014-2512

Phone

(801) 424-9922

NPI assigned

Jan 12, 2026

Organization subpart

No

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

Authorized official

Name

Jonathan Barker, ADMINISTRATION

Title

Manager

Phone

(801) 499-2373

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Practitioners 1

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

• Gon T Lam, NP

  • Family Nurse Practitioner
  • SLC, UT
  • NPI 1891179339

  Family Medicine

  Medicare reassignment NPD

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

{
    "created_epoch": "1768176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768176000000",
    "number": "1891653523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "776 E 800 S",
            "city": "CENTERVILLE",
            "state": "UT",
            "postal_code": "840142512",
            "telephone_number": "801-424-9922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "776 E 800 S",
            "city": "CENTERVILLE",
            "state": "UT",
            "postal_code": "840142512",
            "telephone_number": "801-424-9922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVED WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-12",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A",
        "authorized_official_last_name": "BARKER",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "801-499-2373",
        "authorized_official_credential": "ADMINISTRATION"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas E Rechis, REGISTERED PHARMACIS
• Karen Redd, LCMHC
• Reid Physical Therapy
• Nanette F Reid, PT
• Reignhaven Financial
• Cari Reyes, CSW
• Daniel Rich
• Andrew Rigby, DMD
• Brian D Rigby, DMD
• Kieley J Ritzinger

• Family Medicine Physician in Centerville, UT
• Providers in Centerville, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2026; 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.