Revival Psychiatry and Ketamine Clinic
NPI 1235847286 · Psychiatric/Mental Health Nurse Practitioner · Mesa, AZ
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Revival Psychiatry and Ketamine Clinic is a Psychiatric/Mental Health Nurse Practitioner organization in Mesa, AZ (NPI 1235847286).
Provider details
- NPI number
- 1235847286
- Entity type
- Organization
- Primary specialty
- Psychiatric/Mental Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Erin Jones, Owner/Provider(480) 613-8162
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
- Multi-Specialty Clinic/Center261QM1300X
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 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
Mailing address
Registry dates
- Enumerated
- 2022-11-08
- Last updated
- 2022-11-08
- Certified
- 2022-11-08
Frequently asked questions
- What is Revival Psychiatry and Ketamine Clinic's NPI number?
- Revival Psychiatry and Ketamine Clinic's National Provider Identifier (NPI) is 1235847286, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Revival Psychiatry and Ketamine Clinic?
- Revival Psychiatry and Ketamine Clinic is classified in the NPPES registry as Psychiatric/Mental Health Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Revival Psychiatry and Ketamine Clinic located?
- Revival Psychiatry and Ketamine Clinic's practice location on file with NPPES is 1220 S Alma School Rd Ste 212, Mesa, AZ 85210-2087.
- What is Revival Psychiatry and Ketamine Clinic's phone number?
- The practice phone number listed in the NPPES registry for Revival Psychiatry and Ketamine Clinic is (480) 613-8162.
- Does Revival Psychiatry and Ketamine Clinic accept Medicare?
- Revival Psychiatry and Ketamine Clinic 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 Revival Psychiatry and Ketamine Clinic?
- The authorized official listed on Revival Psychiatry and Ketamine Clinic's NPPES record is Erin Jones, Owner/Provider. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Revival Psychiatry and Ketamine Clinic's NPI active?
- Yes — Revival Psychiatry and Ketamine Clinic's NPI (1235847286) is active in the NPPES registry as of the last update on 2022-11-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.