Jaded Body Wellness & Spine Institute, LLC
NPI 1306108543ActiveOrganization· Physical Therapist· Wasilla, AK
Physical Therapist in Wasilla, Alaska, registered in NPPES in June 2012. The authorized official on file is Caprice Carter, Billing. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1306108543 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 13, 2012 |
| Last updated in NPPES | Oct 28, 2024 |
| Certified by provider | Oct 28, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 2028 | AK |
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 (AK) |
|---|
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