REVIVAL PHYSICAL THERAPY, LLC (NPI# 1518526953) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518526953 |
| Entity Type | Organization |
| Organization Name | REVIVAL PHYSICAL THERAPY, LLC |
| Practice Address |
4116 Swindon Ct Charlotte NC 28215-5355 |
| Practice Telephone | 9802303276 |
| Mailing Telephone | 9802303276 |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2019-06-10 |
| Authorized Official Name | MITCHELL SAMONTE MONTEMAYOR (CEO) |
| Authorized Official Telephone | 9802763066 |
| Authorized Official Credential | PT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081H0002X |
Physical Medicine & Rehabilitation Specialization: Hospice and Palliative Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
4116 SWINDON CT |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28215-5355 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679111769 | Lawana Ussery Hill | Case Management | 1740 Misty Morn Drive, Charlotte, NC 28215 | 2019-12-19 |
| 1053961110 | Tonya Anita Brown | Behavior Technician | 10230 White Oak Rd, Charlotte, NC 28215 | 2019-09-19 |
| 1780242412 | Mikhail A Rybin | Registered Nurse | 7502 Malden Park Drive, Charlotte, NC 28215 | 2019-05-29 |
| 1033698527 | Novant Medical Group, Inc | Internal Medicine | 8201 Healthcare Loop Ste 304, Charlotte, NC 28215 | 2018-08-07 |
| 1538646088 | Andrew Simpson | Pharmacist | 3805 Rocky River Rd, Charlotte, NC 28215 | 2018-07-26 |
| 1154818425 | Korinne A Umlauft | Specialist/Technologist | 8618 Terra Cotta Dr, Charlotte, NC 28215 | 2018-04-22 |
| 1477058196 | Harmony Health Pllc | Community/Behavioral Health | 8633 Pine Circle, Charlotte, NC 28215 | 2018-03-26 |
| 1639671357 | Total Renal Care of North Carolina LLC | Clinic/Center | 9562 Rocky River Rd, Charlotte, NC 28215 | 2018-03-08 |
| 1588166060 | Allcare Medical Center,pllc | Internal Medicine | 7401 The Plaza, Charlotte, NC 28215 | 2018-03-01 |
| 1851891774 | Bio-medical Applications of North Carolina, Inc. | Clinic/Center | 3211 Bishops Way Lane, Charlotte, NC 28215 | 2018-02-16 |
| Find all providers in zip 28215 | ||||
| Taxonomy Code | 2081H0002X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Hospice and Palliative Medicine |
| A physical medicine and rehabilitation physician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This specialist works with an interdisciplinary hospice or palliative care team to maximize quality of life while addressing physical, psychological, social and spiritual needs of both patient and family throughout the course of the disease, through the dying process, and beyond for the family. This specialist has expertise in the assessment of patients with advanced disease; the relief of distressing symptoms; the coordination of interdisciplinary patient and family-centered care in diverse venues; the use of specialized care systems including hospice; the management of the imminently dying patient; and legal and ethical decision making in end-of-life care. |
| Notes: Source: American Academy of Hospice and Palliative Medicine, www.aahpm.org [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225517758 | Mitchell Samonte Montemayor | Physical Medicine & Rehabilitation | 17328 Newlands Corner Ln, Charlotte, NC 28277-2480 | 2018-08-07 |
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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.