Revive Behavioral Health, LLC
NPI 1003601220 · Psychiatric/Mental Health Nurse Practitioner · Mount Vernon, OH
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Revive Behavioral Health, LLC is a Psychiatric/Mental Health Nurse Practitioner organization in Mount Vernon, OH (NPI 1003601220).
Provider details
- NPI number
- 1003601220
- Entity type
- Organization
- Primary specialty
- Psychiatric/Mental Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Jordan Moore, Owner(740) 501-4836
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2025-04-09
- Last updated
- 2025-04-10
- Certified
- 2025-04-10
Frequently asked questions
- What is Revive Behavioral Health, LLC's NPI number?
- Revive Behavioral Health, LLC's National Provider Identifier (NPI) is 1003601220, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Revive Behavioral Health, LLC?
- Revive Behavioral Health, LLC is classified in the NPPES registry as Psychiatric/Mental Health Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Revive Behavioral Health, LLC located?
- Revive Behavioral Health, LLC's practice location on file with NPPES is 206 S Mulberry St Ste a, Mount Vernon, OH 43050-3331.
- What is Revive Behavioral Health, LLC's phone number?
- The practice phone number listed in the NPPES registry for Revive Behavioral Health, LLC is (740) 501-4836.
- Does Revive Behavioral Health, LLC accept Medicare?
- Revive Behavioral Health, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Revive Behavioral Health, LLC?
- The authorized official listed on Revive Behavioral Health, LLC's NPPES record is Jordan Moore, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Revive Behavioral Health, LLC's NPI active?
- Yes — Revive Behavioral Health, LLC's NPI (1003601220) is active in the NPPES registry as of the last update on 2025-04-10.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.