Revive Therapy and Performance, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

REVIVE THERAPY AND PERFORMANCE, LLC

Practice address

324 E 2ND St
Moundridge, KS 67107-7164

Phone

(620) 345-7400

Fax

(620) 345-7410

NPI assigned

Jun 19, 2024

Organization subpart

No

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

Authorized official

Name

Jessanna Grayce SchumannNPI 1841934585

Title

Director of Operations

Phone

(620) 217-0583

Specialties & licenses 9

Addresses

Other names 1

• Revive Therapy and Performance Doing business as

Practitioners 1

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

• Jessanna Grayce Schumann, OT

  • Occupational Therapist
  • Hesston, KS
  • NPI 1841934585
  NPD Authorized official

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

{
    "created_epoch": "1718755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718755200000",
    "number": "1841034535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 E 2ND ST",
            "city": "MOUNDRIDGE",
            "state": "KS",
            "postal_code": "671077164",
            "telephone_number": "620-345-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 E 2ND ST",
            "city": "MOUNDRIDGE",
            "state": "KS",
            "postal_code": "671077164",
            "telephone_number": "620-345-7400",
            "fax_number": "620-345-7410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE THERAPY AND PERFORMANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-19",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A",
        "authorized_official_last_name": "SCHUMANN",
        "authorized_official_first_name": "JESSANNA",
        "authorized_official_middle_name": "GRAYCE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "620-217-0583"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Geriatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Hand",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XR0403X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Driving and Community Mobility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revive Therapy and Performance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pathfinders Physical Therapy & Consulting, P.a.
• Ashlee Nicholle Pauls, P.A.-C
• Leland L Porter, D.C.
• Michelle M Porter, OTR
• James D Ratzlaff, M.D.
• Ashley Dyan Roberts, PT, DPT
• Nichole Marie Schroeder, OTR
• Gaven Schumann
• Michele Miller Sharp, P.A.
• Cindy Lee Stucky, PTA

• Physical Therapist in Moundridge, KS
• Providers in Moundridge, KS by specialty
• Physical Therapist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; 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.