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NPI 1124225008ActiveOrganization· Physical Therapist, Orthopedic· Phoenix, AZ
Physical Therapist, Orthopedic in Phoenix, Arizona, registered in NPPES in July 2007. The authorized official on file is Keith W. Fandry, Clinical Director.
Overview
| NPI | 1124225008 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 2, 2007 |
| Last updated in NPPES | Jul 28, 2020 |
| Certified by provider | Jul 28, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist, Orthopedic Primary | 2251X0800X | — | — |
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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