REVIVE PHYSICAL THERAPY LLC (NPI# 1972133817) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972133817 |
| Entity Type | Organization |
| Organization Name | REVIVE PHYSICAL THERAPY LLC |
| Practice Address |
1665 Bloomfield Place Dr Apt 422 Bloomfield Hills MI 48302-3513 |
| Practice Telephone | 8102103744 |
| Enumeration Date | 2020-01-20 |
| Last Update Date | 2020-07-03 |
| Authorized Official Name | TRE WILLIAMS (OWNER) |
| Authorized Official Telephone | 8105555555 |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457819534 | Revive Physical Therapy LLC | Physical Medicine & Rehabilitation | 18019 Sw Lower Boones Ferry Rd, Portland, OR 97224 | 2019-03-07 |
| 1215204110 | Revive Physical Therapy LLC | Clinic/Center | 10300 Baltimore National Pike, Unit #b, Ellicott City, MD 21042-2128 | 2011-11-20 |
| Street Address |
1665 BLOOMFIELD PLACE DR APT 422 |
| City | BLOOMFIELD HILLS |
| State | MI |
| Zip Code | 48302-3513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386242634 | Lamuriel Lewis | Registered Nurse | 1430 South Telegraph Rd, Bloomfield Hills, MI 48302 | 2020-10-09 |
| 1730794082 | Ola Glezen | Registered Nurse | 1410 South Telegraph Road, Bloomfield Hills, MI 48302 | 2020-09-14 |
| 1114563400 | Henry Ford Health System | Pharmacy | 1961 S Telegraph Rd, Bloomfield Twp, MI 48302 | 2019-11-21 |
| 1508407982 | P-cor LLC | Eyewear Supplier (Equipment, not the service) | 1961 S. Telegraph Rd, Bloomfield Hills, MI 48302 | 2019-10-07 |
| 1144887936 | Christine Beth Wilson De Medina | Psychologist | W-4111 Andover Road, Bloomfield Hills, MI 48302 | 2019-05-28 |
| 1942793799 | Andrew Joseph Grix | Physical Therapist | 2525 S Telegraph Rd Ste 314, Bloomfield Hills, MI 48302 | 2018-06-06 |
| 1306398078 | Shaleene Mayo | Mechanotherapist | 43902 Woodward # 120, Bloomfield Hills, MI 48302 | 2016-10-28 |
| 1588112981 | Carol Van Kampen | Social Worker | 2550 S. Telegraph, Bloomfield Hills, MI 48302 | 2016-09-14 |
| 1770933848 | Rachelle Savalli | Family Medicine | 1961 South Telegraph Rd, Bloomfield Twp, MI 48302 | 2016-06-20 |
| 1699155366 | Aleksey Mishulin | Ophthalmology | 1750 S Telegraph Ste 205, Bloomfield Hills, MI 48302 | 2015-06-08 |
| Find all providers in zip 48302 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881197481 | Rishi Kishore | Clinic/Center | 5075 N Adams Rd, Bloomfield Hills, MI 48304-2502 | 2018-03-10 |
| 1952766826 | Tririga Rehab LLC | Clinic/Center | 800 W Long Lake Rd Ste 103, Bloomfield Hills, MI 48302-2033 | 2015-12-21 |
| 1154510220 | Stride Physical Therapy Inc. | Clinic/Center | 43750 Woodward Ave, Suite 103, Bloomfield Hills, MI 48302-5063 | 2007-10-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629679485 | Thrive Physical Therapy | Clinic/Center | 835 Mason St Ste A245, Dearborn, MI 48124-2231 | 2020-11-06 |
| 1700484482 | Redford Physical Therapy LLC | Clinic/Center | 25136 W 6 Mile Rd, Redford, MI 48240-2102 | 2020-10-14 |
| 1740894500 | Sara Sue Laisure | Clinic/Center | 1105 E 8th St, Traverse City, MI 49686-2936 | 2020-08-31 |
| 1578176269 | Pro-line Physical Therapy, LLC | Clinic/Center | 25899 W 12 Mile Rd Ste 335, Southfield, MI 48034-8343 | 2020-08-24 |
| 1326650011 | Physical Therapy Center for Sports and Performing Arts, Pllc | Clinic/Center | 30475 Stephenson Hwy, Madison Heights, MI 48071-1615 | 2020-08-23 |
| 1770194607 | Restorative Rehabilitation Inc | Clinic/Center | 9228 Pelham Rd, Taylor, MI 48180-3832 | 2020-08-13 |
| 1528679081 | Activo Physical Therapy, LLC | Clinic/Center | 5140 Coolidge Hwy, Ste 101, Royal Oak, MI 48073 | 2020-08-10 |
| 1114537719 | Axpert Rehab Care, LLC | Clinic/Center | 22830 Kelly Rd, Eastpointe, MI 48021-2072 | 2020-08-07 |
| 1619586898 | Right Health, PC | Clinic/Center | 28345 Beck Rd Ste 412, Wixom, MI 48393-4745 | 2020-07-23 |
| 1497378368 | Launch Pediatric Rehab | Clinic/Center | 13448 Greenbriar Dr, Grand Haven, MI 49417-9161 | 2020-05-26 |
| Find all providers with the same taxonomy | ||||
| City | BLOOMFIELD HILLS |
| Zip Code | 48302 |
Please comment or provide details below to improve the information on REVIVE PHYSICAL THERAPY 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.