Elite Rehab LLC
NPI 1205792850ActiveOrganization· Physical Therapist· Kirksville, MO
Physical Therapist in Kirksville, Missouri, registered in NPPES in December 2025. The authorized official on file is Brandon Lee Mack, Owner. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1205792850 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 29, 2025 |
| Last updated in NPPES | Apr 28, 2026 |
| Certified by provider | Apr 28, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
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 Part B Supplier - Physical/Occupational Therapy Group in Private Practice (MO) |
|---|
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