| Revive Integrative Health Llc. | |
|
645 E Iron Ave Ste C Salina KS 67401-2697 | |
| (785) 577-5736 | |
| (785) 200-3765 |
| Full Name | Revive Integrative Health Llc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 645 E Iron Ave Ste C, Salina, Kansas |
| Authorized Official Name and Position | Shayla Trost (OWNER/PHYSICAL THERAPIST) |
| Authorized Official Contact | 7855775736 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Revive Integrative Health Llc. 645 E Iron Ave Ste C Salina KS 67401-2697 Ph: (785) 577-5736 | Revive Integrative Health Llc. 645 E Iron Ave Ste C Salina KS 67401-2697 Ph: (785) 577-5736 |
| NPI Number | 1184387235 |
|---|---|
| Provider Enumeration Date | 10/15/2021 |
| Last Update Date | 05/13/2026 |
| Certification Date | 05/13/2026 |
| Medicare PECOS PAC ID | 1456729193 |
|---|---|
| Medicare Enrollment ID | O20221130000986 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184387235 | NPI | - | NPPES |
| Provider Name | Shayla L Trost |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1760868533 PECOS PAC ID: 5698105328 Enrollment ID: I20200421002301 |
| Provider Name | Angela Christine Kingsbury |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427662865 PECOS PAC ID: 7517387798 Enrollment ID: I20201009001693 |
| Provider Name | Kourtney Kincaid |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1568060069 PECOS PAC ID: 0547678138 Enrollment ID: I20210420002299 |
| Provider Name | Megan E Pengra |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1245056423 PECOS PAC ID: 9133644347 Enrollment ID: I20250421002023 |
| Provider Name | Rylee M Wright |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1639982556 PECOS PAC ID: 4385160845 Enrollment ID: I20250428002540 |
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