Innovative Physiatry Spine Clinic, LLC
NPI 1487175881ActiveOrganization· Physical Medicine & Rehabilitation, Pain Medicine· St Johns, FL
Physical Medicine & Rehabilitation, Pain Medicine in St Johns, Florida, registered in NPPES in July 2017. The authorized official on file is Seck Lim, Practice Administrator. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1487175881 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 6, 2017 |
| Last updated in NPPES | Sep 2, 2021 |
| Certified by provider | Sep 2, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Medicine & Rehabilitation, Pain Medicine Primary | 2081P2900X | OS12124 | FL |
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 - Clinic/Group Practice (FL) |
|---|
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