Revolution Physical Therapy LLC
NPI 1518469063ActiveOrganization· Physical Therapist· Southaven, MS
Physical Therapist in Southaven, Mississippi, registered in NPPES in March 2018. The authorized official on file is Amy Graham, DPT, Owner. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1518469063 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 1, 2018 |
| Last updated in NPPES | Apr 29, 2026 |
| Certified by provider | Apr 29, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
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 Part B Supplier - Physical/Occupational Therapy Group in Private Practice (MS) |
|---|
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