Independent Physical Therapy of Ga, LLC
NPI 1508424250ActiveOrganization· Physical Therapist· Statesboro, GA
Physical Therapist in Statesboro, Georgia, registered in NPPES in May 2019. The authorized official on file is Kevin Johanneson, Vp Revenue Cycle.
Overview
| NPI | 1508424250 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 29, 2019 |
| Last updated in NPPES | May 29, 2019 |
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 · 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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