Revive Primary Care and Medspa PLLC
NPI 1457203879 · Gerontology Nurse Practitioner · La Follette, TN
Revive Primary Care and Medspa PLLC is a Gerontology Nurse Practitioner organization in La Follette, TN (NPI 1457203879).
Provider details
- NPI number
- 1457203879
- Entity type
- Organization
- Primary specialty
- Gerontology Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Heidi Marlow, Agnp-Cb(937) 408-7606
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
Under 1 yr in 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
- 2026-02-10
- Last updated
- 2026-02-10
- Certified
- 2026-02-10
Frequently asked questions
- What is Revive Primary Care and Medspa PLLC's NPI number?
- Revive Primary Care and Medspa PLLC's National Provider Identifier (NPI) is 1457203879, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Revive Primary Care and Medspa PLLC?
- Revive Primary Care and Medspa PLLC is classified in the NPPES registry as Gerontology Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Revive Primary Care and Medspa PLLC located?
- Revive Primary Care and Medspa PLLC's practice location on file with NPPES is 2221 Jacksboro Pike Ste A18, La Follette, TN 37766-3035.
- What is Revive Primary Care and Medspa PLLC's phone number?
- The practice phone number listed in the NPPES registry for Revive Primary Care and Medspa PLLC is (937) 408-7606.
- Who is the authorized official for Revive Primary Care and Medspa PLLC?
- The authorized official listed on Revive Primary Care and Medspa PLLC's NPPES record is Heidi Marlow, Agnp-Cb. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Revive Primary Care and Medspa PLLC's NPI active?
- Yes — Revive Primary Care and Medspa PLLC's NPI (1457203879) is active in the NPPES registry as of the last update on 2026-02-10.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.