Thrive Neuro Therapy, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

THRIVE NEURO THERAPY, LLC

Practice address

655 River Ave
South Bend, IN 46601-3237

Phone

(231) 329-5518

Fax

(574) 381-5414

NPI assigned

Jan 23, 2024

Last updated

Jan 23, 2024By 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

Doris E Walterhouse, PT, DPTNPI 1699536946

Title

Physical Therapist

Phone

(231) 329-5518

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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.

• Doris Walterhouse, PT, DPT

  • Neurology Physical Therapist
  • South Bend, IN
  • NPI 1699536946
  Medicare reassignment Care Compare group NPD Authorized official
• Mary Lumma Behrens, PT

  • Physical Therapist
  • Mishawaka, IN
  • NPI 1639921539
  Medicare reassignment Care Compare group NPD
• Amy K Shoue, PT

  • Physical Therapist
  • South Bend, IN
  • NPI 1275288631
  Medicare reassignment Care Compare group NPD
• Carlton Smith Jr., OTR/L

  • Occupational Therapist
  • South Bend, IN
  • NPI 1740029446
  Medicare reassignment NPD
• Eric Hummel, OTR

  • Occupational Therapist
  • Michigan City, IN
  • NPI 1841856390
  Medicare reassignment
• Justine Marie Prikosovich, PTA, CNS

  • Physical Therapy Assistant
  • North Liberty, IN
  • NPI 1558122994
  NPD

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

{
    "created_epoch": "1705968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705968000000",
    "number": "1700647054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 233",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466240233",
            "telephone_number": "231-329-5518",
            "fax_number": "574-381-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 RIVER AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466013237",
            "telephone_number": "231-329-5518",
            "fax_number": "574-381-5414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THRIVE NEURO THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-23",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-22",
        "status": "A",
        "authorized_official_last_name": "WALTERHOUSE",
        "authorized_official_first_name": "DORIS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "231-329-5518",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shaune Thompson, LMHC
• Erik Michael Thordarson, MD
• Meadow Thornsberry
• Julie Anne Thornton, MSPT
• Shannon Thorpe-Hannon, MA
• Thrive Psychological Services
• Katherine Tian, MD
• Dyllan Tiburzi
• Elysia N Tidey
• James William Tieman, M.D.

• Physical Therapy Clinic/Center in South Bend, IN
• Providers in South Bend, IN by specialty
• Physical Therapy Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; 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.