Revita Rehab North LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

REVITA REHAB NORTH LLC

Doing business as

Revita Rehab North

Practice address

203 E Dalke Ave
Suite B
Spokane, WA 99208-8112

Phone

(509) 489-4249

Fax

(509) 483-8338

NPI assigned

Apr 20, 2012

Organization subpart

No

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

Authorized official

Name

Beth Elmore

Title

Office Manager

Phone

(509) 489-4249

Specialties & licenses 2

Addresses

Other names 1

• Revita Rehab North Doing business as

Locations

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

{
    "created_epoch": "1334880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339718400000",
    "number": "1457618902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 E DALKE AVE",
            "address_2": "SUITE B",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992088112",
            "telephone_number": "509-489-4249",
            "fax_number": "509-483-8338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 E DALKE AVE",
            "address_2": "SUITE B",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992088112",
            "telephone_number": "509-489-4249",
            "fax_number": "509-483-8338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVITA REHAB NORTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-20",
        "last_updated": "2012-06-15",
        "status": "A",
        "authorized_official_last_name": "ELMORE",
        "authorized_official_first_name": "BETH",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "509-489-4249"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revita Rehab North",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Physical Therapist in Spokane, WA
• Providers in Spokane, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2012; 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.