REVIVE PHYSICAL THERAPY LLC (NPI# 1215204110) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215204110 |
| Entity Type | Organization |
| Organization Name | REVIVE PHYSICAL THERAPY LLC |
| Practice Address |
10300 Baltimore National Pike Unit #b Ellicott City MD 21042-2128 |
| Practice Telephone | 4433644495 |
| Mailing Telephone | 4433644495 |
| Enumeration Date | 2011-11-20 |
| Last Update Date | 2011-11-20 |
| Authorized Official Name | MS. RENUKA JAIN (OWNER/PHYSICAL THERAPIST) |
| Authorized Official Telephone | 4433644495 |
| Authorized Official Credential | DPT, COMT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
22176 | MD | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972133817 | Revive Physical Therapy LLC | Clinic/Center | 1665 Bloomfield Place Dr Apt 422, Bloomfield Hills, MI 48302-3513 | 2020-01-20 |
| 1457819534 | Revive Physical Therapy LLC | Physical Medicine & Rehabilitation | 18019 Sw Lower Boones Ferry Rd, Portland, OR 97224 | 2019-03-07 |
| Street Address |
10300 BALTIMORE NATIONAL PIKE UNIT #B |
| City | ELLICOTT CITY |
| State | MD |
| Zip Code | 21042-2128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700847480 | Amaka J Undie | Pediatrics | 10300 Baltimore National Pike, A, Ellicott City, MD 21042-2128 | 2006-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861950792 | Danielle Coliukos | Student in an Organized Health Care Education/Training Program | 3006 Fawnwood Dr, Ellicott City, MD 21042 | 2019-03-11 |
| 1700356110 | Sung Hee Moon | Acupuncturist | 9005 Chevrolet Dr #4, Ellicott City, MD 21042 | 2018-11-28 |
| 1902375009 | Sharon N Allen | Speech-Language Pathologist | Hcpss, 10910 Clarksville Pike, Ellicott City, MD 21042 | 2018-11-19 |
| 1043700412 | Samirawit Hailemariam | Registered Nurse | 9527 Liverpool Lane, Ellicott City, MD 21042 | 2018-05-11 |
| 1144771965 | Maryland Psychotherapy Services | Community/Behavioral Health | 7054 Dorsey Hall Dr., Suite 104, Ellicott City, MD 21042 | 2016-10-17 |
| 1861851321 | The Lutheran Village At Miller's Grant, Inc. | Skilled Nursing Facility | 9000 Fathers Legacy, Ellicott City, MD 21042 | 2016-02-12 |
| 1942676952 | Hyoung Keun Kim | Dentist | 10033 Baltimore Pike Suite 320, Ellicott City, MD 21042 | 2015-08-13 |
| 1356743553 | Cvs Pharmacy | Pharmacist | 3300a Centennial Lane, Ellicott City, MD 21042 | 2014-09-18 |
| 1821407719 | Zulema Roberts | Counselor | 3355 St. Johns Lane, Suite F, Ellicott City, MD 21042 | 2014-08-05 |
| 1548681638 | Better Life Pain Clinic, Pllc | Physical Medicine & Rehabilitation | 3459 St. John's Lane, Suite 9, Ellicott City, MD 21042 | 2013-12-17 |
| Find all providers in zip 21042 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992830392 | Mcnerney & Associates, P.a. | Clinic/Center | 5024 Dorsey Hall Dr, Suite 103, Ellicott City, MD 21042-7711 | 2007-02-23 |
| 1578576906 | Five Star Rehabilitation and Wellness Services, LLC. | Clinic/Center | 3004 North Ridge Road, Ellicott City, MD 21043-3381 | 2006-08-15 |
| 1811594278 | Restore Pelvic Physical Therapy | Clinic/Center | 5130 Dorsey Hall Dr Fl 1, Ellicott City, MD 21042-7870 | 2020-10-07 |
| 1245768506 | Recharge LLC | Clinic/Center | 5136 Dorsey Hall Dr, Ellicott City, MD 21042-7921 | 2017-05-31 |
| 1164958435 | Physical Therapy At Crossroads, LLC | Clinic/Center | 4801 Dorsey Hall Dr Ste 130, Ellicott City, MD 21042-7763 | 2017-05-05 |
| 1780981449 | Karen Foy | Clinic/Center | 10298b Baltimore National Pike, Ellicott City, MD 21042-3670 | 2011-02-16 |
| 1225281488 | Roy Film Pt, Pa | Clinic/Center | 8492 Baltimore National Pike, Suite 207, Ellicott City, MD 21043-3370 | 2008-10-31 |
| 1265629083 | Rehabcare Services LLC | Clinic/Center | 8335 Autumn River Dr, Ellicott City, MD 21043-7529 | 2007-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144821307 | My Concierge Pt LLC | Clinic/Center | 9141 Gracious End Ct Apt 104, Columbia, MD 21046-2095 | 2020-11-04 |
| 1730794967 | Lz Pt and Wellness, LLC | Clinic/Center | 8375 Jumpers Hole Rd Ste 202, Millersville, MD 21108-1271 | 2020-09-14 |
| 1083224877 | Silver Lining Physical Therapy & Wellness | Clinic/Center | 7050 Oakland Mills Rd Ste 130, Columbia, MD 21046-2269 | 2020-08-06 |
| 1790302925 | Hanson Physical Therapy & Sports Performance | Clinic/Center | 750 State Route 3 S Ste 5, Gambrills, MD 21054-1306 | 2020-07-03 |
| 1891312575 | Flamm Physical Therapy and Wellness, LLC | Clinic/Center | 2801 Guilford Ave, Baltimore, MD 21218-5485 | 2020-06-29 |
| 1073139036 | Woo Physical Therapy and Wellness | Clinic/Center | 8247 Hickory Hollow Dr, Glen Burnie, MD 21060-8721 | 2020-06-24 |
| 1851917892 | Mgpt, LLC | Clinic/Center | 5901 Montrose Rd Apt N402, Rockville, MD 20852-4729 | 2020-06-24 |
| 1811513278 | Manigault Enterprise, L.L.C. | Clinic/Center | 2103 Woodtop Way, Bel Air, MD 21015-6370 | 2020-06-22 |
| 1114543089 | True Sports Physical Therapy, LLC | Clinic/Center | 9030 State Route 108 Ste B, Columbia, MD 21045-1990 | 2020-06-17 |
| 1427673482 | True Sports Physical Therapy, LLC | Clinic/Center | 1305 Governors Ct Ste D, Abingdon, MD 21009-2345 | 2020-06-15 |
| Find all providers with the same taxonomy | ||||
| City | ELLICOTT CITY |
| Zip Code | 21042 |
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.