REVIVE THERAPY (NPI# 1730711060) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730711060 |
| Entity Type | Organization |
| Organization Name | REVIVE THERAPY |
| Practice Address |
3100 W Lakeway Rd Ste 1 Gillette WY 82718-6373 |
| Practice Telephone | 3076221242 |
| Practice Fax Number | 3073330375 |
| Mailing Telephone | 3076221242 |
| Mailing Fax Number | 3073330375 |
| Enumeration Date | 2020-02-05 |
| Last Update Date | 2020-03-30 |
| Authorized Official Name | TRACI SMITH (OWNER) |
| Authorized Official Telephone | 3076221242 |
| Authorized Official Credential | OT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | REVIVE THERAPY INC. | 568 Waterloo Rd Suite 100, Warrenton, Virginia 20186 |
| Colorado Business Entities | Revive Therapy LLC | 826 S Tejon St A, Colorado Springs, CO 80903 |
| Iowa Business Entities | REVIVE THERAPY SERVICES, LLC | 210 Se Wanda Dr, Ankeny, IA 50021 |
| Street Address |
3100 W LAKEWAY RD STE 1 |
| City | GILLETTE |
| State | WY |
| Zip Code | 82718-6373 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881691905 | Sara L Hartsaw | Surgery | 3100 W Lakeway Rd Ste 1, Gillette, WY 82718-6373 | 2005-07-05 |
| 1194912428 | Traci Marie Smith | Occupational Therapist | 3100 W Lakeway Rd Ste 1, Gillette, WY 82718-6373 | 2007-10-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912413964 | Kaylyn Brook Bahnson | Pharmacist | 2000 South Douglas Hwy Walgreens Pharmacy, Gillette, WY 82718 | 2017-12-28 |
| 1205373073 | Cheryl Trembath | Counselor | 201 West Lakeway Rd, Suite 1004, Gillette, WY 82718 | 2017-01-31 |
| 1043769078 | Employment Testing Services | Clinical Medical Laboratory | 3805 South Douglas Hwy, Unit 1, Gillette, WY 82718 | 2016-10-03 |
| 1750730339 | Caritas Mental Health LLC | Community/Behavioral Health | 5204 Raven St, Gillette, WY 82718 | 2016-06-06 |
| 1902298029 | Jena Cowen | Day Training, Developmentally Disabled Services | 5305 Cowen Drive, Gillette, WY 82718 | 2015-02-26 |
| 1720480635 | Brenda Kay Upton | Pharmacist | 2300 S Douglas Highway, Gillette, WY 82718 | 2014-09-23 |
| 1891127825 | Bighorn Dental Clinic PC | Dentist | 4403 Running W. Drive, Gillette, WY 82718 | 2013-08-01 |
| 1750726212 | High Desert Healthcare LLC | Clinic/Center | 1013 East Boxelder Rd, Suite 200, Gillette, WY 82718 | 2013-05-09 |
| 1225224231 | County of Campbell | Public Health or Welfare | 2301 South 4j Rd, Gillette, WY 82718 | 2007-09-24 |
| 1043424336 | Lowell R Amiotte II | Anesthesiology | 3100 W Lakeway Suite 3, Northern Plains Anesthesia Associates, Gillette, WY 82718 | 2007-05-09 |
| Find all providers in zip 82718 | ||||
| Taxonomy Code | 225X00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapist |
| An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life. |
| Notes: Source: The Guide to Occupational Therapy Practice, 2nd edition. Bethesda: American Occupational Therapy Association, 2007. [7/1/2008: definition changed, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144483330 | Anni Jean Stafford | Occupational Therapist | 1211 S Douglas Hwy Ste 100, Gillette, WY 82716-4982 | 2008-07-08 |
| 1235756776 | Alisha Roberts | Occupational Therapist | 1211 S Douglas Hwy Ste 100, Gillette, WY 82716-4982 | 2020-07-01 |
| 1184258915 | Caitlin Cordell | Occupational Therapist | 1211 S Douglas Hwy, Gillette, WY 82716-4949 | 2020-03-02 |
| 1063054211 | Kalin Hale | Occupational Therapist | 1013 E Boxelder Rd Ste 100, Gillette, WY 82718-5936 | 2019-10-09 |
| 1982266094 | Laura Allen | Occupational Therapist | 508 Stocktrail Ave Ste D, Gillette, WY 82716-3582 | 2019-06-28 |
| 1629534102 | Laura L Roush | Occupational Therapist | 1211 S Douglas Hwy Ste 100, Gillette, WY 82716-4982 | 2019-02-20 |
| 1164948071 | Shayna Rae Carpenter | Occupational Therapist | 1211 S Douglas Hwy Ste 100, Gillette, WY 82716-4982 | 2017-08-22 |
| 1508380049 | Brittney C Barelman | Occupational Therapist | 508 Stocktrail Ave, Gillette, WY 82716-3582 | 2017-07-26 |
| 1932637501 | Janine Nicole Albert | Occupational Therapist | 508 Stocktrail Ave Ste D, Gillette, WY 82716-3582 | 2017-05-26 |
| 1063944239 | Lindsey Ann Hall | Occupational Therapist | 1211 S Douglas Hwy, Suite 130, Gillette, WY 82716-4949 | 2017-03-28 |
| Find all providers in GILLETTE | ||||
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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.