Rogue Physio LLC
NPI 1104704824ActiveOrganization· Physical Therapist· Oak Ridge, TN
Physical Therapist in Oak Ridge, Tennessee, registered in NPPES in August 2025. The authorized official on file is Michael David Blair, PT DPT, Owner/ Physical Therapist. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1104704824 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 21, 2025 |
| Last updated in NPPES | Dec 1, 2025 |
| Certified by provider | Dec 1, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Physical/Occupational Therapy Group in Private Practice (TN) |
|---|
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