Revival Wellness, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

REVIVAL WELLNESS, LLC

Practice address

1949 N Highway 99
Emporia, KS 66801-8163

Phone

(620) 412-3381

NPI assigned

Aug 24, 2022

Organization subpart

No

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

Authorized official

Name

Mrs. Taylor Danielle Kirk, DPTNPI 1023631256

Title

Physical Therapist

Phone

(620) 412-3381

Specialties & licenses 1

Addresses

Practitioners 1

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

• Taylor Danielle Kirk, DPT

  • Physical Therapist
  • Emporia, KS
  • NPI 1023631256
  NPD Authorized official

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661299200000",
    "number": "1720707565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1949 N HIGHWAY 99",
            "city": "EMPORIA",
            "state": "KS",
            "postal_code": "668018163",
            "telephone_number": "620-412-3381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1949 N HIGHWAY 99",
            "city": "EMPORIA",
            "state": "KS",
            "postal_code": "668018163",
            "telephone_number": "620-412-3381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVAL WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-24",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A",
        "authorized_official_last_name": "KIRK",
        "authorized_official_first_name": "TAYLOR",
        "authorized_official_middle_name": "DANIELLE",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "620-412-3381",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Damon Redeker, BS
• Morgan Lea Redeker, PHARMD
• Amy D Reed, LMFT
• Paul E Reimer, OD
• Renal Care Group of the Midwest Inc
• Viridiana Reyes Coria
• Reynolds & Anliker Eye Physicians & Surgeons LLC
• Reynolds & Anliker Eye Physicians & Surgeons, PA
• Michael George Reynolds, M.D.
• Kaytlyn Rice

• Physical Therapy Clinic/Center in Emporia, KS
• Providers in Emporia, KS by specialty
• Physical Therapy Clinic/Center in Kansas

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