Independent Physical Therapy of Ga LLC
NPI 1679088975ActiveOrganization· Physical Therapist· Augusta, GA
Physical Therapist in Augusta, Georgia, registered in NPPES in December 2017. The authorized official on file is Kevin Johanneson, Vp Revenue Cycle.
Overview
| NPI | 1679088975 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 8, 2017 |
| Last updated in NPPES | Jan 10, 2023 |
| Certified by provider | Jan 10, 2023 |
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 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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