REVIVE WELLNESS & REJUVENATION (NPI# 1770930166) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770930166 |
| Entity Type | Organization |
| Organization Name | REVIVE WELLNESS & REJUVENATION |
| Practice Address |
13934 N 59th Ave Suite 100 Glendale AZ 85306-4167 |
| Practice Telephone | 6025957836 |
| Practice Fax Number | 6024192210 |
| Mailing Telephone | 6025957836 |
| Mailing Fax Number | 6024192210 |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2016-05-16 |
| Authorized Official Name | MS. STEPHANIE KNOX (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 6025957836 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians |
| Street Address |
13934 N 59TH AVE SUITE 100 |
| City | GLENDALE |
| State | AZ |
| Zip Code | 85306-4167 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700864733 | Stephanie Elaine Clark | Audiologist | 13934 N 59th Ave, Ste 120, Glendale, AZ 85306-4167 | 2006-01-09 |
| 1649511163 | Integrity Health & Wellness Center LLC | Family Medicine | 13934 N 59th Ave, Suite 100, Glendale, AZ 85306-4167 | 2013-03-07 |
| 1396098414 | Erdmann Chiropractic L.l.c | Nurse Practitioner | 13934 N 59th Ave, Ste. 100, Glendale, AZ 85306 | 2012-10-26 |
| 1750645073 | Kelly Jean Halterman | Audiologist-Hearing Aid Fitter | 13934 N 59th Ave, Suite 120, Glendale, AZ 85306-4167 | 2012-07-02 |
| 1053542175 | Arizona Wellness Chiropractic, LLC | Chiropractor | 13934 N 59th Ave, 100, Glendale, AZ 85306-4167 | 2009-08-06 |
| 1356570378 | Arizona Clinic of Gastroenterology PC | Internal Medicine | 13934 N 59th Ave, Suite 160, Glendale, AZ 85306-4167 | 2009-07-12 |
| 1467658948 | Sally Ann Teodoro | Audiologist | 13934 N 59th Ave, Glendale, AZ 85306-4167 | 2007-06-22 |
| 1225257181 | Jared Paul Trimble | Audiologist | 13934 N 59th Ave, Glendale, AZ 85306-4167 | 2007-04-25 |
| 1083839666 | Metro Hearing Associates, LLC | Audiologist | 13934 N 59th Ave, Suite # 120, Glendale, AZ 85306-4167 | 2007-04-17 |
| 1740301399 | Dan Trimble | Audiologist | 13934 N 59th Ave, Suite 120, Glendale, AZ 85306-4167 | 2007-04-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548784648 | Michelle Weissgerber | Registered Nurse | 6640 W Maui Ln, Glendale, AZ 85306 | 2017-07-31 |
| 1427502947 | Az Interact LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6055 West Caribe Lane, Glendale, AZ 85306 | 2016-08-12 |
| 1649667635 | Richard Moreno Jr. | Physical Therapy Assistant | 6509 W Acapulco Ln, Glendale, AZ 85306 | 2015-04-17 |
| 1568863819 | Alternative Living for You | Assisted Living Facility | 5328 W. Tierra Buena Ln., Glendale, AZ 85306 | 2014-09-05 |
| 1649614561 | Matthew Brownell | Internal Medicine | 5555 W, Thunderbird, Banner Thunderbird Medical Center, Glendale, AZ 85306 | 2013-04-22 |
| 1366736266 | Miles Christenson | Speech-Language Pathologist | 14627 N 60th Ave, Glendale, AZ 85306 | 2011-06-08 |
| 1285928721 | Nathalie Tania Petein-alamshaw | Internal Medicine | 5555 W Thunderbird Road, Glendale, AZ 85306 | 2011-06-01 |
| 1134351869 | William J. Duff | Counselor | 5701 W. Talavi Boulevard, Suite 180, Phoenix, AZ 85306 | 2009-08-13 |
| 1538321369 | Cardiovascular Consultants, Ltd | Non-Pharmacy Dispensing Site | 5422 W. Thunderbird, Suite 8, Glendale, AZ 85306 | 2008-07-02 |
| 1316109143 | Cardiovascular Consultants, Ltd | Non-Pharmacy Dispensing Site | 5620 W. Thunderbird, Suite D3, Glendale, AZ 85306 | 2008-07-02 |
| Find all providers in zip 85306 | ||||
| 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 |
|---|---|---|---|---|
| 1588130447 | Bryan R Ching | Physical Medicine & Rehabilitation | 1809 Verdugo Blvd Ste 160, Glendale, CA 91208-1417 | 2018-10-18 |
| 1124512496 | Robin Blunck | Physical Medicine & Rehabilitation | 6630 W Cactus Rd Ste B112-113, Glendale, AZ 85304-1600 | 2018-06-19 |
| 1619469699 | Honorhealth Medical Group, LLC | Physical Medicine & Rehabilitation | 6220 W Bell Rd Ste 130, Glendale, AZ 85308-3896 | 2018-06-05 |
| 1861993586 | Harry Wong | Physical Medicine & Rehabilitation | 17100 North 67th Ave, Bld 1, Suite 100, Glendale, AZ 85308-3612 | 2018-02-27 |
| 1265932180 | Lord Christopher Bagacina Larcena | Physical Medicine & Rehabilitation | 212 W Garfield Ave Apt 108, Glendale, CA 91204-2146 | 2018-02-16 |
| 1376042705 | Eileen Wong, Md Inc. | Physical Medicine & Rehabilitation | 2664 E Glenoaks Blvd, Glendale, CA 91206 | 2018-02-12 |
| 1841712908 | 360 Physical Therapy LLC | Physical Medicine & Rehabilitation | 6630 W Cactus Rd Ste B112, Glendale, AZ 85304-1662 | 2017-07-11 |
| 1497924864 | Maxim Moradian | Physical Medicine & Rehabilitation | 1500 S Central Ave Ste 101, Glendale, CA 91204-2563 | 2008-02-29 |
| 1427236868 | Prodynamic Care Physical Therapy, Pllc | Physical Medicine & Rehabilitation | 78-01 Myrtle Ave, Glendale, NY 11385-7439 | 2008-02-07 |
| 1245419829 | Wellness P.t. & Rehab, Inc | Physical Medicine & Rehabilitation | 425 W Broadway, Suite 112, Glendale, CA 91204-4118 | 2007-10-30 |
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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.