REVIVE PHYSICAL THERAPY LLC (NPI# 1457819534) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457819534 |
| Entity Type | Organization |
| Organization Name | REVIVE PHYSICAL THERAPY LLC |
| Practice Address |
18019 Sw Lower Boones Ferry Rd Portland OR 97224 |
| Practice Telephone | 5036912723 |
| Practice Fax Number | 5036925406 |
| Mailing Telephone | 5036912723 |
| Mailing Fax Number | 5036925406 |
| Enumeration Date | 2019-03-07 |
| Last Update Date | 2019-03-07 |
| Authorized Official Name | KENTON MARC BROOK (PRESIDENT) |
| Authorized Official Telephone | 5036912723 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians |
| 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 |
| 1215204110 | Revive Physical Therapy LLC | Clinic/Center | 10300 Baltimore National Pike, Unit #b, Ellicott City, MD 21042-2128 | 2011-11-20 |
| Street Address |
18019 SW LOWER BOONES FERRY RD |
| City | PORTLAND |
| State | OR |
| Zip Code | 97224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790131233 | Brady Fielding | Chiropractor | 18019 Sw Lower Boones Ferry Rd, Portland, OR 97224-7228 | 2016-05-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154973139 | Katherine Raineri | Psychologist | 7213 Sw Hazel Fern Rd, Tigard, OR 97224 | 2019-07-10 |
| 1871064618 | Stacey A Wenzel | Speech-Language Pathologist | 17020 Sw Upper Boones Ferry Rd.,suite 201, Tigard, OR 97224 | 2018-12-05 |
| 1376010090 | Meredith Rae Brezinski | Physical Therapist | 18019 Sw Boones Ferry Road, Tigard, OR 97224 | 2018-10-31 |
| 1649759358 | Viktoriya A Chiliy | Behavior Technician | 15290 Sw Royalty Parkway, Tigard, OR 97224 | 2018-08-13 |
| 1609384866 | Rachel E King | Physical Therapist | 18040 Sw Lower Boones Ferry Rd Ste 200, Tigard, OR 97224 | 2018-01-22 |
| 1689190134 | Isabelle Cooper Klee Caballero | Speech-Language Pathologist | 17020 Sw Upper Boones Ferry Road Suite 201, Tigard, OR 97224 | 2017-08-16 |
| 1427573146 | Breanna M Sandefur | Behavior Technician | 15290 Sw Royalty Pkwy, Tigard, OR 97224 | 2017-08-03 |
| 1083141196 | Krista Espenship | Registered Nurse | 8032 Sw Ashford St, Tigard, OR 97224 | 2017-05-19 |
| 1275067928 | Emily Elizabeth Myers | Behavioral Analyst | 15290 Royalty Parkway, Tigard, OR 97224 | 2017-04-19 |
| 1235684937 | Melanie Salvador | Nurse Practitioner | 15352 Sw Oakmont Pl, Tigard, OR 97224 | 2016-08-23 |
| Find all providers in zip 97224 | ||||
| Taxonomy Code | 208100000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Physical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and treating patients with physical disabilities. These disabilities may arise from conditions affecting the musculoskeletal system such as neck and back pain, sports injuries, or other painful conditions affecting the limbs, such as carpal tunnel syndrome. Alternatively, the disabilities may result from neurological trauma or disease such as spinal cord injury, head injury or stroke. A physician certified in physical medicine and rehabilitation is often called a physiatrist. The primary goal of the physiatrist is to achieve maximal restoration of physical, psychological, social and vocational function through comprehensive rehabilitation. Pain management is often an important part of the role of the physiatrist. For diagnosis and evaluation, a physiatrist may include the techniques of electromyography to supplement the standard history, physical, x-ray and laboratory examinations. The physiatrist has expertise in the appropriate use of therapeutic exercise, prosthetics (artificial limbs), orthotics and mechanical and electrical devices. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. American Osteopathic Board of Physical Medicine and Rehabilitation, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Physical Medicine and Rehabilitation. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457987836 | Gurleen K Grewal | Physical Medicine & Rehabilitation | 402 Nw 12th Ave, Portland, OR 97209-2907 | 2020-03-18 |
| 1558842054 | Ryan Thomas Willoughby | Physical Medicine & Rehabilitation | 15640 Nw Laidlaw Rd Ste 202, Portland, OR 97229-3828 | 2018-08-23 |
| 1659874238 | Karrie Silva, Lmt | Physical Medicine & Rehabilitation | 1427 Nw 23rd Ave Ste 1, Portland, OR 97210-2645 | 2018-03-09 |
| 1477921021 | Kara Rich | Physical Medicine & Rehabilitation | 1706 Ne 114th Ave, Portland, OR 97220 | 2015-09-11 |
| 1003135658 | New Leaf Physical and Massage Therapy, LLC | Physical Medicine & Rehabilitation | 4050 Ne Broadway St, Portland, OR 97232-1828 | 2010-05-21 |
| 1427381029 | Heather Block | Physical Medicine & Rehabilitation | 13243 Se Buford Ct, Portland, OR 97236-3186 | 2009-09-14 |
| 1386873040 | Bessie Joy Perkey | Physical Medicine & Rehabilitation | 507 Ne 47th Ave Ste 102d, Portland, OR 97213-2236 | 2009-07-02 |
| 1609002492 | Paul Gerrard | Physical Medicine & Rehabilitation | 110 Marginal Way, Portland, ME 04101-2442 | 2009-06-08 |
| 1013112721 | Stephanie K Liu | Physical Medicine & Rehabilitation | 10940 Sw Barnes Rd # 375, Portland, OR 97225-5368 | 2007-06-21 |
| 1982807590 | John Halisey Kennedy | Physical Medicine & Rehabilitation | 4040 Sw 53rd Pl, Portland, OR 97221-2015 | 2007-06-09 |
| Find all providers in PORTLAND | ||||
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| 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.