Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Revive Family Medical Clinic, LLC

Organization Clinic/Center · NPI 1902577554

Revive Family Medical Clinic, LLC is a Clinic/Center in Columbus, Mississippi. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3549 Bluecutt Rd
Columbus, MS 39705-1324
Phone: (662) 386-1541
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinic/Center (primary) Taxonomy 261Q00000X

Record details

NPI number1902577554
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Micah Grant — Nurse Practitioner · (662) 570-4174
NPI enumeratedSeptember 23, 2021
Last updated in NPPESNovember 18, 2021
Certification dateNovember 18, 2021
Mailing address3549 Bluecutt Rd, Columbus, MS 39705-1324

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