REVERT LLC (NPI# 1568857118) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568857118 |
| Entity Type | Organization |
| Organization Name | REVERT LLC |
| Practice Address |
634 N Falmouth Hwy Unit 10 North Falmouth MA 02556 |
| Mailing Address |
111 Two Ponds Rd Falmouth MA 02540-2221 |
| Practice Telephone | 5083563952 |
| Practice Fax Number | 5084372597 |
| Mailing Telephone | 5083563952 |
| Mailing Fax Number | 5084372597 |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2018-12-10 |
| Authorized Official Name | DR. BARON EDWARD DUFFY (MANAGING MEMBER) |
| Authorized Official Telephone | 7743920612 |
| Authorized Official Credential | PT, DPT, OCS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 181 Goeletta Dr, East Falmouth, MA 025363968 | 5085348693 | 5084372597 |
| 111 Two Ponds Rd, Falmouth, MA 025402221 | 5083563952 | 5084372597 |
| Street Address |
634 N FALMOUTH HWY UNIT 10 |
| City | NORTH FALMOUTH |
| State | MA |
| Zip Code | 02556 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902077399 | Baron Edward Duffy | Physical Therapist | 634 N Falmouth Hwy Unit 10, North Falmouth, MA 02556-0326 | 2008-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598064677 | Kenneth Martin | Physician Assistant | 26 Edgerton Drive, North Falmouth, MA 02556 | 2011-03-15 |
| 1750413647 | Susan W Baur | Psychologist | 82 County Road, North Falmouth, MA 02556 | 2007-03-09 |
| 1952465866 | Maria T Batilo | Internal Medicine | 37 Edgerton Dr. Unit #3, North Falmouth, MA 02556 | 2006-12-22 |
| 1194815597 | Karen Smith Rohrberg | Nurse Practitioner | 107 County Rd, N Falmouth, MA 02556 | 2006-10-14 |
| 1942306766 | William Work Jr. | Optometrist | 634 Route 28a, No Falmouth, MA 02556 | 2006-09-16 |
| 1538191846 | Mark A Liska | Dermatology | 37 Edgerton Drive, Ste 1, North Falmouth, MA 02556 | 2006-07-07 |
| 1407806888 | Nancy K Barnett | Dermatology | 37 Edgerton Dr, Ste 1, North Falmouth, MA 02556 | 2006-05-10 |
| 1275599805 | Robert R Moore | Internal Medicine | 4 Edgerton Dr, North Falmouth, MA 02556 | 2006-04-22 |
| 1043474018 | James Boyd Vereen | Family Medicine | 33 Edgerton Dr, North Falmouth, MA 02556 | 2008-07-17 |
| 1184836405 | Audrey J Tobin | Nurse Practitioner | 4 Edgerton Dr, N Falmouth, MA 02556 | 2007-05-07 |
| Find all providers in zip 02556 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013518448 | Shira Lauren Dragun | Clinic/Center | 63 1/2 Jefferson Ave, Salem, MA 01970-2975 | 2020-11-03 |
| 1518564566 | Ann Pappas Physical Therapy | Clinic/Center | 470 Washington St Ste 31, Norwood, MA 02062-2343 | 2020-10-02 |
| 1538786272 | Neurologic Optimal Wellness Physical Therapy LLC | Clinic/Center | 180 King St, Springfield, MA 01109-4316 | 2020-06-29 |
| 1689297525 | Full Spectrum Physical Therapy and Performance, LLC | Clinic/Center | 17 Cannongate Rd Apt 83, Tyngsboro, MA 01879-1413 | 2020-05-27 |
| 1992328421 | Adam Auto Accident Physio Doctor,inc | Clinic/Center | 1011 Beacon St Ste 1, Brookline, MA 02446-5696 | 2020-05-19 |
| 1952938839 | Jessica Moy Wellness LLC | Clinic/Center | 255 Massachusetts Ave Apt 204, Boston, MA 02115-3511 | 2020-03-23 |
| 1598390940 | The Method Performance and Physical Therapy LLC | Clinic/Center | 378 North St Apt 2, Boston, MA 02113-2143 | 2020-03-05 |
| 1104458785 | Olender Physical Therapy, LLC | Clinic/Center | 316 Washington St Ste 1, Wellesley, MA 02481-4959 | 2020-02-11 |
| 1851930028 | Core Physical Therapy & Performance, LLC | Clinic/Center | 11 Randolph Rd, Randolph, MA 02368-4321 | 2020-01-05 |
| 1316585482 | Healthworks Med Group of Massachusetts P C | Clinic/Center | 157 Berkeley St, Boston, MA 02116-5108 | 2019-12-19 |
| Find all providers with the same taxonomy | ||||
| City | NORTH FALMOUTH |
| Zip Code | 02556 |
Please comment or provide details below to improve the information on REVERT LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.