NPIMap

Organization Active NPI

Revive Rehab Inc

  • Physical Therapist
  • Jacksonville, FL
National Provider Identifier
1962734210
Registry record updated May 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
REVIVE REHAB INC
Practice address
4745 Sutton Park CT Ste 403
Jacksonville, FL 32224-0255
Phone
(904) 371-4649
Fax
(888) 393-1099
NPI assigned
Feb 10, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2026

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

Authorized official

Name
Darly ThoppilNPI 1952633208
Title
President
Phone
(904) 472-8846

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

4745 Sutton Park CT Ste 403
Jacksonville, FL 32224-0255

Mailing address

151 Sawgrass Corners Dr
Suite # 117
Ponte Vedra Beach, FL 32082-3553
Phone (904) 472-8846

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100602000164 FL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8527197441 Receives reassigned benefits from 7 practitioners
Practice locations: Jacksonville, FL

National Provider Directory

National Provider Directory

Locations

13500 Sutton Park Dr S
Ste 302
Jacksonville, FL 32224
Phone (904) 371-4649

4745 Sutton Park Ct
Ste 403
Jacksonville, FL 32224
Phone (904) 371-4649

151 Sawgrass Corners Dr
Ste 117
Ponte Vedra Beach, FL 32082
Phone (904) 371-4649

151 Sawgrass Corners Dr
Ste 109
Ponte Vedra Beach, FL 32082
Phone (904) 371-1397

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1265760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779148800000",
    "number": "1962734210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 SAWGRASS CORNERS DR",
            "address_2": "SUITE # 117",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320823553",
            "telephone_number": "904-472-8846",
            "fax_number": "888-393-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4745 SUTTON PARK CT STE 403",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322240255",
            "telephone_number": "904-371-4649",
            "fax_number": "888-393-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE REHAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-10",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A",
        "authorized_official_last_name": "THOPPIL",
        "authorized_official_first_name": "DARLY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-472-8846"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

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