Revolution Sports and Performance LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

REVOLUTION SPORTS AND PERFORMANCE LLC

Doing business as

Revolution Performance Physical Therapy

Practice address

27774 Autumn Breeze Cir
Wesley Chapel, FL 33544-7839

Phone

(813) 838-2510

NPI assigned

Jul 5, 2019

Last updated

Jun 14, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Matthew David Blevins, DPTNPI 1134119076

Title

Ceo/Owner

Phone

(813) 838-2510

Specialties & licenses 5

Addresses

Other names 2

• Revolution Performance Physical Therapy Doing business as
• Revolution Sports Physical Therapy and Performance Former legal business name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew D Blevins, PT

  • Orthopedic Physical Therapist
  • Temple Terrace, FL
  • NPI 1134119076
  NPD Authorized official

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

{
    "created_epoch": "1562284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623628800000",
    "number": "1538721907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27774 AUTUMN BREEZE CIR",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335447839",
            "telephone_number": "813-838-2510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27774 AUTUMN BREEZE CIR",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335447839",
            "telephone_number": "813-838-2510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVOLUTION SPORTS AND PERFORMANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-05",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A",
        "authorized_official_last_name": "BLEVINS",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "813-838-2510",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revolution Performance Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Revolution Sports Physical Therapy and Performance",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Physical Therapy Clinic/Center in Wesley Chapel, FL
• Providers in Wesley Chapel, FL by specialty
• Physical Therapy Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.