Revitalize Physical Therapy PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

REVITALIZE PHYSICAL THERAPY PLLC

Practice address

425 Broadway
Medora, ND 58645

Phone

(701) 872-6724

Fax

(701) 353-2073

NPI assigned

Jan 10, 2022

Organization subpart

No

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

Authorized official

Name

Hannah Lee Freiboth, PT, DPTNPI 1104586841

Title

Owner

Phone

(701) 872-6724

Specialties & licenses 1

Addresses

Other names 1

• Revitalize Physical Therapy PLLC Doing business as

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Locations

Practitioners 4

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

• Hannah Lee Freiboth, DPT

  • Physical Therapist
  • Dickinson, ND
  • NPI 1104586841
  Medicare reassignment NPD Authorized official
• Samuel Edward Bisson, DC

  • Chiropractor
  • Dickinson, ND
  • NPI 1225658164
  NPD (past)
• Rebecca Ann Kasian, DC

  • Chiropractor
  • Medora, ND
  • NPI 1518341296
  NPD (past)
• Eric Seiler, DC

  • Chiropractor
  • Dickinson, ND
  • NPI 1225664691
  NPD (past)

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

{
    "created_epoch": "1641772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788134400000",
    "number": "1861153090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 BROADWAY",
            "city": "MEDORA",
            "state": "ND",
            "postal_code": "58645",
            "telephone_number": "701-872-6724",
            "fax_number": "701-353-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 BROADWAY",
            "city": "MEDORA",
            "state": "ND",
            "postal_code": "58645",
            "telephone_number": "701-872-6724",
            "fax_number": "701-353-2073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVITALIZE PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-10",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A",
        "authorized_official_last_name": "FREIBOTH",
        "authorized_official_first_name": "HANNAH",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-872-6724",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revitalize Physical Therapy PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• County of Billings
• County of Billings
• Rebecca Ann Kasian, DC

• Physical Therapist in Medora, ND
• Providers in Medora, ND by specialty
• Physical Therapist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; 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.