Independent Physical Therapy of Georgia, LLC
NPI 1457608861ActiveOrganization· Physical Therapist· Canton, GA
Physical Therapist in Canton, Georgia, registered in NPPES in August 2012. The authorized official on file is Kevin Johanneson, Vp Revenue Cycle. Enrolled in Medicare as dme supplier - independently-practicing physical therapist.
Overview
| NPI | 1457608861 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 6, 2012 |
| Last updated in NPPES | May 10, 2017 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
| Occupational Therapist | 225X00000X | — | — |
| Speech-Language Pathologist | 235Z00000X | — | — |
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) | Enrolled DME Supplier - Independently-Practicing Physical Therapist (GA) |
|---|
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