Revive Dearborn PLLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

REVIVE DEARBORN PLLC

Practice address

5225 Auto Club Dr Ste 101
Dearborn, MI 48126-2620

Phone

(248) 819-1703

NPI assigned

Oct 1, 2021

Organization subpart

No

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

Authorized official

Name

Yousef Almadrahi

Title

Office Manager

Phone

(248) 828-6924

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1633046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633046400000",
    "number": "1447922026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5225 AUTO CLUB DR STE 101",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262620",
            "telephone_number": "248-819-7103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 AUTO CLUB DR STE 101",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262620",
            "telephone_number": "248-819-1703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE DEARBORN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-01",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A",
        "authorized_official_last_name": "ALMADRAHI",
        "authorized_official_first_name": "YOUSEF",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "248-828-6924"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Unknown Reshma Bano Shahzadi, MD
• Kathryn Ressler
• Adnan Restum
• Shadi Restum
• Lisa Reuter, PA-C
• Yorwie Reyes-Rodriguez
• Bevelyn Reyes
• Sarah Lynn Reyes
• Zachary Adam Reynolds
• Tiffany Rhodes, CRNA

• Physical Medicine & Rehabilitation Physician in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Physical Medicine & Rehabilitation Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.