IV League Health & Wellness
NPI 1619728243ActiveOrganization· Family Medicine· San Angelo, TX
Family Medicine in San Angelo, Texas, registered in NPPES in April 2024. The authorized official on file is Elizabeth Jacobo, Credentialing Manager.
Overview
| NPI | 1619728243 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 1, 2024 |
| Last updated in NPPES | Apr 1, 2024 |
| Certified by provider | Mar 31, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
| Clinic/Center, Infusion Therapy | 261QI0500X | — | — |
| Clinic/Center, Primary Care | 261QP2300X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 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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