Revive Physical Therapy and Wellness, PLLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

9950 Issued in AZ

Legal business name

REVIVE PHYSICAL THERAPY AND WELLNESS, PLLC

Practice address

4703 S Lakeshore Dr Ste 2
Tempe, AZ 85282

Phone

(480) 718-9493

NPI assigned

Jul 28, 2015

Last updated

Jun 4, 2018By 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

Dayna MonterreyNPI 1598193419

Title

Owne

Phone

(480) 718-9493

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 6

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.

• Andres Meza

  • Physical Therapist
  • Tempe, AZ
  • NPI 1932769668
  Medicare reassignment Care Compare group NPD
• Saeed Monterrey, DPT

  • Physical Therapist
  • Tempe, AZ
  • NPI 1396093084
  Medicare reassignment Care Compare group NPD
• Rebecca N Reynolds, PT, DPT

  • Physical Therapist
  • Mesa, AZ
  • NPI 1386146413
  Medicare reassignment Care Compare group NPD
• Cole Bembenek, DPT

  • Physical Therapist
  • Tempe, AZ
  • NPI 1932926540
  Medicare reassignment NPD
• Angelica Rodriguez, DPT

  • Physical Therapist
  • New York, NY
  • NPI 1215711072

  AZ

  Medicare reassignment NPD
• Dayna Monterrey, N.M.D

  • Naturopath
  • Tempe, AZ
  • NPI 1598193419
  NPD (past) Authorized official

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

{
    "created_epoch": "1438041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528070400000",
    "number": "1689059917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4703 S LAKESHORE DR STE 2",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827159",
            "telephone_number": "480-718-9493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4703 S LAKESHORE DR STE 2",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "85282",
            "telephone_number": "480-718-9493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE PHYSICAL THERAPY AND WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-28",
        "last_updated": "2018-06-04",
        "status": "A",
        "authorized_official_last_name": "MONTERREY",
        "authorized_official_first_name": "DAYNA",
        "authorized_official_title_or_position": "OWNE",
        "authorized_official_telephone_number": "480-718-9493"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "AZ",
            "license": "9950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "734323",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Restorative Healing and Counseling Center LLC (Rhacc)
• Laurel Retay, DO
• Revamp Wellness Center
• Revive Community Health (Revive Community Health LLC)
• Revive Hive LLC
• Jascelyn Ann Revland, M.A.
• Reyes Family Medicine, PLC
• James A Reyes
• Martha L Reyes, MD
• Ricardo Reyes Jr.

• Physical Therapy Clinic/Center in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Physical Therapy Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2018; 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.