Vital Village Physical Therapy
NPI 1255119319ActiveOrganization· Physical Therapist· Woodstock, GA
Physical Therapist in Woodstock, Georgia, registered in NPPES in September 2023. The authorized official on file is Shaun Underwood, Owner. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1255119319 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 20, 2023 |
| Last updated in NPPES | Sep 20, 2023 |
| Certified by provider | Sep 20, 2023 |
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 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 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 (GA) |
|---|
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