Revive Physical Therapy, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

REVIVE PHYSICAL THERAPY, LLC

Practice address

980 Ute LN
Gunnison, CO 81230-8704

Phone

(719) 251-8593

NPI assigned

Oct 14, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Taren Colleen Frazier, PT, DPTNPI 1114395415

Title

Physical Therapist

Phone

(719) 251-8593

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Locations

Practitioners 1

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

• Taren Frazier, DPT

  • Orthopedic Physical Therapist
  • Gunnison, CO
  • NPI 1114395415
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1571011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578355200000",
    "number": "1962044735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 UTE LN",
            "city": "GUNNISON",
            "state": "CO",
            "postal_code": "812308704",
            "telephone_number": "719-251-8593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 UTE LN",
            "city": "GUNNISON",
            "state": "CO",
            "postal_code": "812308704",
            "telephone_number": "719-251-8593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-14",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A",
        "authorized_official_last_name": "FRAZIER",
        "authorized_official_first_name": "TAREN",
        "authorized_official_middle_name": "COLLEEN",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "719-251-8593",
        "authorized_official_name_prefix": "Dr.",
        "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": []
}

• Stephanie Lynn Porter, MD
• Nickolas Evangelos Poulos, D.O.
• Sarah Michelle Quinlivan
• Stacy Rae, L.AC.
• Valerie Ramos
• Sherry Rice
• Julie Ann Richardson, LCSW
• Rocky Mountain Clinics LLC
• Rocky Mountain Hyperbaric Institute -Gunnison LLC
• Jaime Rodriguez, CEP

• Physical Therapist in Gunnison, CO
• Providers in Gunnison, CO by specialty
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2020; 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.