Rev Sports Rehab & Athletic Development, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PT021258 Issued in PA

Legal business name

REV SPORTS REHAB & ATHLETIC DEVELOPMENT, LLC

Practice address

290 Executive Dr
Suite #103
Cranberry TWP, PA 16066-6436

Phone

(724) 612-4747

NPI assigned

Jan 18, 2012

Last updated

Jan 18, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Aimee SlatteryNPI 1043581507

Title

Sports Medicine Physical Therapist

Phone

(724) 612-4747

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Aimee Slattery, PT, MS, CSCS

  • Sports Physical Therapist
  • Cranberry TWP, PA
  • NPI 1043581507
  Authorized official Same address or phone
• Elizabeth Stebbins, PT

  • Physical Therapist
  • Glenshaw, PA
  • NPI 1124625249
  NPD (past)

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326844800000",
    "number": "1992076368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 EXECUTIVE DR",
            "address_2": "UNIT #103",
            "city": "CRANBERRY TWP",
            "state": "PA",
            "postal_code": "160666436",
            "telephone_number": "724-612-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 EXECUTIVE DR",
            "address_2": "SUITE #103",
            "city": "CRANBERRY TWP",
            "state": "PA",
            "postal_code": "160666436",
            "telephone_number": "724-612-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REV SPORTS REHAB & ATHLETIC DEVELOPMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-18",
        "last_updated": "2012-01-18",
        "status": "A",
        "authorized_official_last_name": "SLATTERY",
        "authorized_official_first_name": "AIMEE",
        "authorized_official_title_or_position": "SPORTS MEDICINE PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "724-612-4747"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "PA",
            "license": "PT021258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana M Raub, MD
• Irina Anatolevna Rectenwald, M.S., NCC
• Victoria Reich, LSW
• Lisa Reichert, PT
• Resilient Chiropractic PLLC
• Revenant Chiropractic
• Rhoads Orthodontic Specialist
• Stephanie Golubic Rhoads, DMD, MBE, MS
• Amber Rhodes, LPC
• Ridge Wellness & Counseling Services LLC

• Physical Therapy Clinic/Center in Cranberry TWP, PA
• Providers in Cranberry TWP, PA by specialty
• Physical Therapy Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; 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.