Revive Neurorecovery Center Clt LLC
NPI 1679201123ActiveOrganization· Physical Therapist· Fort Mill, SC
Physical Therapist in Fort Mill, South Carolina, registered in NPPES in August 2022. The authorized official on file is Ashley Clark, DPT, Owner.
Overview
| NPI | 1679201123 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 11, 2022 |
| Last updated in NPPES | Feb 25, 2024 |
| Certified by provider | Feb 25, 2024 |
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) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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