Full Spectrum Pediatric Therapy, Inc.
NPI 1255472403ActiveOrganization· Physical Therapist· Clarksville, TN
Physical Therapist in Clarksville, Tennessee, registered in NPPES in February 2007. The authorized official on file is Lana Kareen Broome, OTR/L, Owner/President. Enrolled in Medicare as part a provider - outpatient physical therapy/occupational therapy/speech pathology services.
Overview
| NPI | 1255472403 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 9, 2007 |
| Last updated in NPPES | Apr 20, 2022 |
| Certified by provider | Apr 20, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | PT 6520 | TN |
| Occupational Therapist | 225X00000X | OT 2156 | TN |
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 A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services (TN) |
|---|
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