Revive Medspa LLC

Primary specialty

Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X

Legal business name

REVIVE MEDSPA LLC

Practice address

11350 McCormick Rd Ste 800
Hunt Valley, MD 21031-1002

Phone

(410) 261-6199

NPI assigned

May 7, 2024

Organization subpart

No

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

Authorized official

Name

Brandi TanasescuNPI 1700344397

Title

Cfo

Phone

(410) 812-5871

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Brandi Tanasescu

  • Mental Health Counselor
  • Baltimore, MD
  • NPI 1700344397
  NPD Authorized official

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

{
    "created_epoch": "1715040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715040000000",
    "number": "1992553903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11350 MCCORMICK RD STE 800",
            "city": "HUNT VALLEY",
            "state": "MD",
            "postal_code": "210311002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11350 MCCORMICK RD STE 800",
            "city": "HUNT VALLEY",
            "state": "MD",
            "postal_code": "210311002",
            "telephone_number": "410-261-6199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE MEDSPA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-07",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A",
        "authorized_official_last_name": "TANASESCU",
        "authorized_official_first_name": "BRANDI",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "410-812-5871"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Malisa Redmond
• Lachae Reeder
• Rehabilitation Resources of Maryland, Inc.
• Camryn Renn
• Amber Renner
• Meghan Catherine Reynolds, PT, DPT
• Victoria Rhoades, PT, DPT
• Dustin Rhodes
• Thomas W Rhodes, DMD
• Michael Rice

• Preventive Medicine/Occupational Environmental Medicine Physician in Hunt Valley, MD
• Providers in Hunt Valley, MD by specialty
• Preventive Medicine/Occupational Environmental Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.