OrganizationActive
Revived Vitality
NPI 1992588750 · Clinic/Center · Myrtle Beach, SC
Revived Vitality is a Clinic/Center organization in Myrtle Beach, SC (NPI 1992588750).
Provider details
- NPI number
- 1992588750
- Entity type
- Organization
- Primary specialty
- Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jennings Perry, Owner/Provider(843) 855-2299
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(63/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 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
1301 48th Ave N # A-2
Myrtle Beach, SC 29577-5427
Phone: (843) 580-3694
Street-level locationGet directions
Mailing address
606 Bald Eagle Dr Ste 201
Marco Island, FL 34145-2731
Additional practice locations (1)
- 606 Bald Eagle Dr Ste 201Marco Island, FL 34145-2731Phone: (843) 855-2299Fax: (843) 353-2564
Registry dates
- Enumerated
- 2023-08-16
- Last updated
- 2023-08-16
- Certified
- 2023-08-16
Frequently asked questions
- What is Revived Vitality's NPI number?
- Revived Vitality's National Provider Identifier (NPI) is 1992588750, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Revived Vitality?
- Revived Vitality is classified in the NPPES registry as Clinic/Center (Ambulatory Health Care Facilities).
- Where is Revived Vitality located?
- Revived Vitality's practice location on file with NPPES is 1301 48th Ave N # A-2, Myrtle Beach, SC 29577-5427.
- What is Revived Vitality's phone number?
- The practice phone number listed in the NPPES registry for Revived Vitality is (843) 580-3694.
- Who is the authorized official for Revived Vitality?
- The authorized official listed on Revived Vitality's NPPES record is Jennings Perry, Owner/Provider. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Revived Vitality's NPI active?
- Yes — Revived Vitality's NPI (1992588750) is active in the NPPES registry as of the last update on 2023-08-16.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.