OrganizationActive
Revive Family Medical Clinic, LLC
NPI 1902577554 · Clinic/Center · Columbus, MS
Revive Family Medical Clinic, LLC is a Clinic/Center organization in Columbus, MS (NPI 1902577554).
Provider details
- NPI number
- 1902577554
- Entity type
- Organization
- Primary specialty
- Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Micah Grant, Nurse Practitioner(662) 570-4174
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(61/100 index)
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
3549 Bluecutt Rd
Columbus, MS 39705-1324
Phone: (662) 386-1541
Street-level locationGet directions
Mailing address
3549 Bluecutt Rd
Columbus, MS 39705-1324
Registry dates
- Enumerated
- 2021-09-23
- Last updated
- 2021-11-18
- Certified
- 2021-11-18
Frequently asked questions
- What is Revive Family Medical Clinic, LLC's NPI number?
- Revive Family Medical Clinic, LLC's National Provider Identifier (NPI) is 1902577554, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Revive Family Medical Clinic, LLC?
- Revive Family Medical Clinic, LLC is classified in the NPPES registry as Clinic/Center (Ambulatory Health Care Facilities).
- Where is Revive Family Medical Clinic, LLC located?
- Revive Family Medical Clinic, LLC's practice location on file with NPPES is 3549 Bluecutt Rd, Columbus, MS 39705-1324.
- What is Revive Family Medical Clinic, LLC's phone number?
- The practice phone number listed in the NPPES registry for Revive Family Medical Clinic, LLC is (662) 386-1541.
- Who is the authorized official for Revive Family Medical Clinic, LLC?
- The authorized official listed on Revive Family Medical Clinic, LLC's NPPES record is Micah Grant, Nurse Practitioner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Revive Family Medical Clinic, LLC's NPI active?
- Yes — Revive Family Medical Clinic, LLC's NPI (1902577554) is active in the NPPES registry as of the last update on 2021-11-18.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.