Independent Physical Therapy, LLC
NPI 1447654058ActiveOrganization· Physical Therapist· Stone Mountain, GA
Physical Therapist in Stone Mountain, Georgia, registered in NPPES in October 2014. The authorized official on file is Kevin Johanneson, Vp Revenue Cycle Manager.
Overview
| NPI | 1447654058 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 11, 2014 |
| Last updated in NPPES | Oct 24, 2022 |
| Certified by provider | Oct 24, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
| Occupational Therapist | 225X00000X | — | — |
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) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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