R L Conerly Jr., OT
NPI 1174741557ActiveIndividual· Physical Therapy Assistant· Ridgeland, MS
Physical Therapy Assistant (OT) in Ridgeland, Mississippi, licensed in MS, with an NPI issued in April 2007. Enrolled in Medicare as practitioner - occupational therapist in private practice.
Overview
| NPI | 1174741557 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | OT |
| Sole proprietor | Yes |
| NPI issued | Apr 23, 2007 |
| Last updated in NPPES | Sep 11, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapy Assistant Primary | 225200000X | PTA2379 | MS |
| Occupational Therapist | 225X00000X | OT1963 | MS |
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 Practitioner - Occupational Therapist in Private Practice (MS) |
|---|
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