Custom Rehab LLC
NPI 1215204862ActiveOrganization· Physical Therapist· Chubbuck, ID
Physical Therapist in Chubbuck, Idaho, registered in NPPES in November 2011. The authorized official on file is Jared L. McKee, PT, Owner. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1215204862 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 28, 2011 |
| Last updated in NPPES | Nov 30, 2011 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
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) | Enrolled Part B Supplier - Physical/Occupational Therapy Group in Private Practice (ID) |
|---|
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