Revitalize Medical Supply
NPI 1508533209 · Clinical Medical Laboratory · Idaho Falls, ID
Enrolled with Medicare as Part B Supplier - Independent Clinical Laboratory · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Revitalize Medical Supply is a Clinical Medical Laboratory organization in Idaho Falls, ID (NPI 1508533209).
Provider details
- NPI number
- 1508533209
- Entity type
- Organization
- Primary specialty
- Clinical Medical LaboratoryLaboratories
- Organization subpart
- No
- Authorized official
- Whitney Whitworth, Owner(208) 589-0821
Specialties & taxonomies
Laboratories
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 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
Other names (DBA / former)
- Doing business as
- Healix Diagnostics
Registry dates
- Enumerated
- 2021-08-30
- Last updated
- 2025-01-17
- Certified
- 2025-01-17
Frequently asked questions
- What is Revitalize Medical Supply's NPI number?
- Revitalize Medical Supply's National Provider Identifier (NPI) is 1508533209, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Revitalize Medical Supply?
- Revitalize Medical Supply is classified in the NPPES registry as Clinical Medical Laboratory (Laboratories).
- Where is Revitalize Medical Supply located?
- Revitalize Medical Supply's practice location on file with NPPES is 1680 Elk Creek Dr # 2, Idaho Falls, ID 83404-1225.
- What is Revitalize Medical Supply's phone number?
- The practice phone number listed in the NPPES registry for Revitalize Medical Supply is (208) 757-4325.
- Does Revitalize Medical Supply accept Medicare?
- Revitalize Medical Supply 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 Revitalize Medical Supply?
- The authorized official listed on Revitalize Medical Supply's NPPES record is Whitney Whitworth, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Revitalize Medical Supply's NPI active?
- Yes — Revitalize Medical Supply's NPI (1508533209) is active in the NPPES registry as of the last update on 2025-01-17.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.