Revival Health and Wellness Clinic
NPI 1366241507 · Family Medicine Physician · Salem, IL
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Revival Health and Wellness Clinic is a Family Medicine Physician organization in Salem, IL (NPI 1366241507).
Provider details
- NPI number
- 1366241507
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Crea Rose, Owner/ Provider(706) 889-8349
Specialties & taxonomies
Allopathic & Osteopathic Physicians
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
- 2025-03-11
- Last updated
- 2025-06-27
- Certified
- 2025-06-27
Frequently asked questions
- What is Revival Health and Wellness Clinic's NPI number?
- Revival Health and Wellness Clinic's National Provider Identifier (NPI) is 1366241507, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Revival Health and Wellness Clinic?
- Revival Health and Wellness Clinic is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Revival Health and Wellness Clinic located?
- Revival Health and Wellness Clinic's practice location on file with NPPES is 207 E Main St, Salem, IL 62881-2926.
- What is Revival Health and Wellness Clinic's phone number?
- The practice phone number listed in the NPPES registry for Revival Health and Wellness Clinic is (706) 889-8349.
- Does Revival Health and Wellness Clinic accept Medicare?
- Revival Health and Wellness 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 Health and Wellness Clinic?
- The authorized official listed on Revival Health and Wellness Clinic's NPPES record is Crea Rose, Owner/ Provider. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Revival Health and Wellness Clinic's NPI active?
- Yes — Revival Health and Wellness Clinic's NPI (1366241507) is active in the NPPES registry as of the last update on 2025-06-27.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.