Revive Physical Therapy, LLC
NPI 1962044735ActiveOrganization· Physical Therapist· Gunnison, CO
Physical Therapist in Gunnison, Colorado, registered in NPPES in October 2019. The authorized official on file is Taren Colleen Frazier, PT, DPT, Physical Therapist. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1962044735 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 14, 2019 |
| Last updated in NPPES | Jan 7, 2020 |
| Certified by provider | Jan 7, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (CO) |
|---|
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