Idaho Pediatric Therapy Clinic PLLC
NPI 1194125617ActiveOrganization· Physical Therapist· Meridian, ID
Physical Therapist in Meridian, Idaho, registered in NPPES in September 2014. The authorized official on file is Jennifer Longoria, Office Manager.
Overview
| NPI | 1194125617 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 3, 2014 |
| Last updated in NPPES | Jul 9, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | PT-1450 | ID |
| Occupational Therapist | 225X00000X | OT-928 | ID |
| Speech-Language Pathologist | 235Z00000X | SLP-2249 | ID |
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) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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