Hailey Sport and Spine Physical Therapy PA
NPI 1184612772ActiveOrganization· Physical Therapist· Hailey, ID
Physical Therapist in Hailey, Idaho, registered in NPPES in October 2005. The authorized official on file is Kimberly A. Mazik, PT, Owner.
Overview
| NPI | 1184612772 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 8, 2005 |
| Last updated in NPPES | Aug 22, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 1168 | ID |
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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