Revitalized Wellness PLLC
NPI 1760093025 · Primary Care Clinic/Center · Sioux Falls, SD
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Revitalized Wellness PLLC is a Primary Care Clinic/Center organization in Sioux Falls, SD (NPI 1760093025).
Provider details
- NPI number
- 1760093025
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Kristi Ross, Owner(251) 979-9825
Specialties & taxonomies
Ambulatory Health Care Facilities
- Professional Counselor101YP2500X
Behavioral Health & Social Service Providers
- Primary Care Nurse Practitioner363LP2300X
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
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
3 documented practice locations
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
Additional practice locations (2)
- 6310 Bayshore Rd # 240Palmetto, FL 34221-8429Phone: (605) 423-7557Fax: (605) 305-1175
- 74 E 18th Ave Ste 12Eugene, OR 97401-4081Phone: (605) 423-7557Fax: (605) 305-1175
Registry dates
- Enumerated
- 2020-08-11
- Last updated
- 2024-03-07
- Certified
- 2024-03-07
Frequently asked questions
- What is Revitalized Wellness PLLC's NPI number?
- Revitalized Wellness PLLC's National Provider Identifier (NPI) is 1760093025, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Revitalized Wellness PLLC?
- Revitalized Wellness PLLC is classified in the NPPES registry as Primary Care Clinic/Center (Ambulatory Health Care Facilities).
- Where is Revitalized Wellness PLLC located?
- Revitalized Wellness PLLC's practice location on file with NPPES is 326 E 8th St Apt 206, Sioux Falls, SD 57103-7038.
- What is Revitalized Wellness PLLC's phone number?
- The practice phone number listed in the NPPES registry for Revitalized Wellness PLLC is (605) 423-7557.
- Does Revitalized Wellness PLLC accept Medicare?
- Revitalized Wellness PLLC 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 Revitalized Wellness PLLC?
- The authorized official listed on Revitalized Wellness PLLC's NPPES record is Kristi Ross, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Revitalized Wellness PLLC's NPI active?
- Yes — Revitalized Wellness PLLC's NPI (1760093025) is active in the NPPES registry as of the last update on 2024-03-07.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.