Relive Physical Therapy Indiana

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

RELIVE PHYSICAL THERAPY INDIANA

Practice address

11360 Broadway
Crown Point, IN 46307-7197

Phone

(708) 390-3362

Fax

(708) 390-4430

NPI assigned

Feb 25, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

James D JudgeNPI 1265484406

Title

Owner

Phone

(708) 903-3362

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James D Judge, P.T.

  • Physical Therapist
  • Park Ridge, IL
  • NPI 1265484406

  IN

  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1614211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728432000000",
    "number": "1013501477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19070 EVERETT BLVD UNIT 204",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604482073",
            "telephone_number": "708-790-3362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11360 BROADWAY",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463077197",
            "telephone_number": "708-390-3362",
            "fax_number": "708-390-4430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RELIVE PHYSICAL THERAPY INDIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-25",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A",
        "authorized_official_last_name": "JUDGE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-903-3362"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "202102051459916",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHONE",
            "identifier": "7083903362",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@relivetherapypt.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "11360 Broadway",
            "city": "Crown Point",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463077197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rehabtech DME
• Lisa Marie Reick, PTA
• Averyl Reid, MA, QMHP
• Sydney Reinhart
• Brooke Reising, NP
• Marina A Renaldi, BA
• Renew Physicians
• Kristopher Renzi, NP
• Revive Care PT and Wellness Center LLC
• Maria Reyes

• Physical Therapy Clinic/Center in Crown Point, IN
• Providers in Crown Point, IN by specialty
• Physical Therapy Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.