Professional Sportscare & Rehab of West Virginia, LLC
NPI 1407301518ActiveOrganization· Physical Therapist· Charles Town, WV
Physical Therapist in Charles Town, West Virginia, registered in NPPES in August 2016. The authorized official on file is Tasheda Broughton, PESC, Manager, Credentialing.
Overview
| NPI | 1407301518 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 18, 2016 |
| Last updated in NPPES | Nov 1, 2024 |
| Certified by provider | Nov 1, 2024 |
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) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other Physical Therapist providers in Charles Town
- 1386461580
- 1457456394
- 1487925251
- 1629363700
- 1952571655
- 1023418910