Bradley Vandivere, DPT
NPI 1275365520ActiveIndividual· Physical Therapist· Sheridan, AR
Physical Therapist (DPT) with Pro Active Rehab, Inc, practicing in Sheridan, Arkansas. Enrolled in Medicare as practitioner - physical therapist in private practice.
Overview
| NPI | 1275365520 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DPT |
| Sole proprietor | No |
| NPI issued | Aug 15, 2024 |
| Last updated in NPPES | Aug 15, 2024 |
| Certified by provider | Aug 15, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 5546 | AR |
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 Practitioner - Physical Therapist in Private Practice (AR) |
|---|
Education and affiliations
| Graduation year | 2024 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Pro Active Rehab, IncBenton, AR · 15 clinicians
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