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Jerry Joseph Bourassa, PHYSICAL THERAPSIT

NPI 1376721779ActiveIndividual· Specialist· Prescott, AZ

Specialist (PHYSICAL THERAPSIT) in Prescott, Arizona, licensed in AZ, with an NPI issued in February 2008.

Overview

NPI1376721779
StatusActive
Entity typeIndividual
CredentialPHYSICAL THERAPSIT
Sole proprietorYes
NPI issuedFeb 7, 2008
Last updated in NPPESFeb 7, 2008

Specialties and licenses

TaxonomyCodeLicenseState
Specialist Primary174400000X1370AZ

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Nov 10, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026No match—
New York OMIG · Nov 11, 2026No match—
Ohio Medicaid · Nov 11, 2026No match—
Pennsylvania Medicheck · Nov 11, 2026No match—
Washington HCA · Nov 11, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026

Medicare sources and data years

Other Specialist providers in Prescott

All 46 Specialist providers in Prescott · All Specialist providers in Arizona