OrganizationActive
Revere Health PC
NPI 1093764805 · Multi-Specialty Clinic/Center · Provo, UT
Provider details
- NPI number
- 1093764805
- Entity type
- Organization
- Primary specialty
- Multi-Specialty Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jed Harston, Director of Managed Care(801) 812-5012
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs 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
1055 N 500 W
Provo, UT 84604-3305
Phone: (801) 429-8000
Fax: (801) 429-8150
Street-level locationGet directions
Mailing address
1055 N 500 W
Provo, UT 84604-3305
Other names (DBA / former)
- Doing business as
- Revere Health
Registry dates
- Enumerated
- 2006-05-09
- Last updated
- 2025-09-02
- Certified
- 2025-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.