NPIMap

Organization Active NPI

Resilient Physical Therapy & Wellness

  • Physical Therapy Clinic/Center
  • Englewood, OH
National Provider Identifier
1528785136
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
RESILIENT PHYSICAL THERAPY & WELLNESS
Practice address
711 W Wenger Rd Apt 205
Englewood, OH 45322-1920
Phone
(937) 670-6922
NPI assigned
Oct 24, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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

Authorized official

Name
Dr. Jordan Bevins, PT, DPTNPI 1366169971
Title
Manager
Phone
(937) 670-6922

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

711 W Wenger Rd Apt 205
Englewood, OH 45322-1920

Mailing address

711 W Wenger Rd Apt 205
Englewood, OH 45322-1920
Phone (937) 670-6922

Other practice location 1

711 W Wenger Rd Apt 205
Englewood, OH 45322-1920
Phone (937) 670-6922

Other identifiers 1

IdentifierTypeStateIssuer
PT018971OtherOHPT/OT/AT BOARD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jordan.bevins@therapysecure.com Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666569600000",
    "number": "1528785136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 W WENGER RD APT 205",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "453221920",
            "telephone_number": "937-670-6922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 W WENGER RD APT 205",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "453221920",
            "telephone_number": "937-670-6922"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "711 W Wenger Rd Apt 205",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "OH",
            "postal_code": "453221920",
            "country_code": "US",
            "telephone_number": "937-670-6922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RESILIENT PHYSICAL THERAPY & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-24",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A",
        "authorized_official_last_name": "BEVINS",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "937-670-6922",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT/OT/AT BOARD",
            "identifier": "PT018971",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jordan.bevins@therapysecure.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "711 W Wenger Rd Apt 205",
            "city": "Englewood",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453221920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Englewood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; 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.