Advanced Physical Therapy & Sports Medicine SC
NPI 1407857790ActiveOrganization· Physical Medicine & Rehabilitation· Appleton, WI
Physical Medicine & Rehabilitation in Appleton, Wisconsin, registered in NPPES in August 2005. The authorized official on file is Camilla Meyer, Credentialing Specialist. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice and dme supplier - independently-practicing physical therapist.
Overview
| NPI | 1407857790 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 9, 2005 |
| Last updated in NPPES | Mar 10, 2026 |
| Certified by provider | Mar 10, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Medicine & Rehabilitation Primary | 208100000X | — | — |
| Clinic/Center, Physical Therapy | 261QP2000X | — | — |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — |
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 (MI); DME Supplier - Independently-Practicing Physical Therapist (WI); Part B Supplier - Clinic/Group Practice (WI) |
|---|
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