Five Corners Physical Therapy S.C.
NPI 1427195304ActiveOrganization· Speech-Language Pathologist· Cedarburg, WI
Speech-Language Pathologist in Cedarburg, Wisconsin, registered in NPPES in January 2007. The authorized official on file is Timothy John Provencher, PT, President.
Overview
| NPI | 1427195304 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 31, 2007 |
| Last updated in NPPES | Sep 11, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Speech-Language Pathologist Primary | 235Z00000X | 1504-154 | WI |
| Physical Therapist | 225100000X | 4146-024 | WI |
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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