Proactive Physical Therapy PC
NPI 1609093434ActiveOrganization· Physical Therapist· Burley, ID
Physical Therapist in Burley, Idaho, registered in NPPES in April 2007. The authorized official on file is Raulan Young, MPT, President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1609093434 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 20, 2007 |
| Last updated in NPPES | Oct 13, 2010 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | PT1299 | ID |
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 (ID) |
|---|
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