Independent Physical Therapy of Ga, LLC
NPI 1063943256ActiveOrganization· Physical Therapist· Roswell, GA
Physical Therapist in Roswell, Georgia, registered in NPPES in March 2017. The authorized official on file is Kevin Johanneson, Vp Revenue Cycle.
Overview
| NPI | 1063943256 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 21, 2017 |
| Last updated in NPPES | Mar 21, 2017 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
| Occupational Therapist | 225X00000X | — | — |
| Speech-Language Pathologist | 235Z00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 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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