Independent Physical Therapy of Ga, LLC
NPI 1083162978ActiveOrganization· Physical Therapist· Pooler, GA
Physical Therapist in Pooler, Georgia, registered in NPPES in September 2016. The authorized official on file is Kevin Johanneson, Vp Of Revenue.
Overview
| NPI | 1083162978 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 20, 2016 |
| Last updated in NPPES | Sep 20, 2016 |
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 · 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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All 29 physical therapists in Pooler · All physical therapists in Georgia