Organization Active NPI

Revive Injury and Rehab

  • Chiropractor
  • Pantego, TX
National Provider Identifier
1710682729
Registry record updated Mar 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
REVIVE INJURY AND REHAB
Practice address
2313 W Arkansas LN Ste 102
Pantego, TX 76013-6034
Phone
(817) 642-5032
NPI assigned
Mar 31, 2023
Last updated
Mar 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2023

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

Authorized official

Name
Djorn Bain, DCNPI 1740770353
Title
Doctor of Chiropractic
Phone
(817) 642-5032

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

2313 W Arkansas LN Ste 102
Pantego, TX 76013-6034

Mailing address

2313 W Arkansas LN Ste 102
Pantego, TX 76013-6034
Phone (817) 642-5032

Other practice location 1

8585 N Stemmons Fwy Ste 440S
Dallas, TX 75247-3836
Phone (817) 642-5032

National Provider Directory

National Provider Directory

Locations

8585 N Stemmons Fwy
Ste 440S
Dallas, TX 75247
Phone (817) 642-5032

2313 W Arkansas Ln
Ste 102
Pantego, TX 76013
Phone (817) 642-5032

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1680220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680220800000",
    "number": "1710682729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2313 W ARKANSAS LN STE 102",
            "city": "PANTEGO",
            "state": "TX",
            "postal_code": "760136034",
            "telephone_number": "817-642-5032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2313 W ARKANSAS LN STE 102",
            "city": "PANTEGO",
            "state": "TX",
            "postal_code": "760136034",
            "telephone_number": "817-642-5032"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8585 N Stemmons Fwy Ste 440S",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752473836",
            "country_code": "US",
            "telephone_number": "817-642-5032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REVIVE INJURY AND REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-31",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A",
        "authorized_official_last_name": "BAIN",
        "authorized_official_first_name": "DJORN",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "817-642-5032",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pantego, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; 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.