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NPI 1184208795ActiveIndividual· Physical Therapist· Goodlettsville, TN

Physical Therapist in Goodlettsville, Tennessee, licensed in TN, with an NPI issued in May 2021.

Overview

NPI1184208795
StatusActive
Entity typeIndividual
Sole proprietorNo
NPI issuedMay 10, 2021
Last updated in NPPESJun 17, 2021
Certified by providerJun 17, 2021

Specialties and licenses

TaxonomyCodeLicenseState
Physical Therapist Primary225100000X13722TN
Physical Therapist225100000X—TN

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 10, 2026No match—
New York OMIG · Nov 10, 2026No match—
Ohio Medicaid · Nov 10, 2026No match—
Pennsylvania Medicheck · Nov 10, 2026No match—
Washington HCA · Nov 10, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026

Medicare sources and data years

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