Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Revive Wellness of Kennesaw LLC

Organization General Practice Physician · NPI 1033049390

Revive Wellness of Kennesaw LLC provides General Practice Physician services in Kennesaw, Georgia. Registered with an NPI since 2026.

In the registry since
2026
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

2819 Dallas St NW
Kennesaw, GA 30144-2705
Phone: (770) 401-6686
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X

Record details

NPI number1033049390
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Julia Everheart — Office Manager · (470) 370-9280
NPI enumeratedMay 20, 2026
Last updated in NPPESJune 24, 2026
Certification dateJune 24, 2026
Mailing address2819 Dallas St Nw, Kennesaw, GA 30144-2705

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