Independent Physical Therapy of Ga LLC
NPI 1578064754ActiveOrganization· Physical Therapist· Lilburn, GA
Physical Therapist in Lilburn, Georgia, registered in NPPES in February 2018. The authorized official on file is Kevin Johanneson, Vp Revenue Cycles.
Overview
| NPI | 1578064754 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 23, 2018 |
| Last updated in NPPES | Feb 23, 2018 |
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) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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