Northwest Physical Therapy Inc
NPI 1114507852ActiveOrganization· Physical Therapist· Azle, TX
Physical Therapist in Azle, Texas, registered in NPPES in April 2021. The authorized official on file is Shane B. Wall, PT, Owner. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1114507852 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 8, 2021 |
| Last updated in NPPES | Jun 15, 2022 |
| Certified by provider | Jun 15, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
| Clinic/Center, Physical Therapy | 261QP2000X | — | — |
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) | Enrolled Part B Supplier - Physical/Occupational Therapy Group in Private Practice (TX) |
|---|
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All 16 physical therapists in Azle · All physical therapists in Texas