Revive Physical Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

REVIVE PHYSICAL THERAPY LLC

Practice address

36180 Dominion Cir
Sterling Heights, MI 48310-7456

Phone

(810) 555-5555

NPI assigned

Jan 20, 2020

Organization subpart

No

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

Authorized official

Name

Tre Williams

Title

Owner

Phone

(810) 555-5555

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1579478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608249600000",
    "number": "1972133817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1665 BLOOMFIELD PLACE DR APT 422",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483023513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36180 DOMINION CIR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483107456",
            "telephone_number": "810-555-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-20",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "TRE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-555-5555"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nadiya Respress
• Tania C Reveggino Sosa de Pinto, R.PH.
• Revive Care Physical Therapy LLC
• Revive Home Healthcare LLC
• Revive Outpatient Services, LLC.
• Kashla Reyes
• Kayla Rezmer
• Iris Annette Rhind
• Chyna Chanel Rhodeman
• Farhat Riaz

• Physical Therapy Clinic/Center in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• Physical Therapy Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; 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.