Professional Sportscare & Rehab, LLC
NPI 1407397896ActiveOrganization· Physical Therapist· Waldorf, MD
Physical Therapist in Waldorf, Maryland, registered in NPPES in March 2017. The authorized official on file is Tasheda Broughton, PESC, Manager, Credentialing.
Overview
| NPI | 1407397896 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 17, 2017 |
| Last updated in NPPES | Dec 6, 2024 |
| Certified by provider | Dec 6, 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 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) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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