Brevard Orthopaedic Spine & Pain Clinic Inc
NPI 1003100504ActiveOrganization· Physical Therapist· Melbourne, FL
Physical Therapist in Melbourne, Florida, registered in NPPES in June 2011, part of Brevard Orthopaedic Spine & Pain Clinic Inc. The authorized official on file is Katrina Lopez, Credentialing.
Overview
| NPI | 1003100504 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Brevard Orthopaedic Spine & Pain Clinic Inc |
| NPI issued | Jun 2, 2011 |
| Last updated in NPPES | Jul 15, 2021 |
| Certified by provider | Jul 15, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
| Chiropractor | 111N00000X | — | — |
| Massage Therapist | 225700000X | — | — |
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) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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